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Book : /Cr ' 5 
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COPYRIGHT DEPOSE 



THE HEALTH-CARE OF THE BABY 



THE 

Health-Care of the Baby 
a handbook 

FOR 

MOTHERS AND NURSES 



BY 

LOUIS FISCHER, M.D. 

Author of "Infant Feeding in Health and Disease"; "A Text-book on Diseases 

of Infancy and Childhood"; Attending Physician to the Willard 

Parker and Riverside Hospitals; Former Instructor in 

Diseases of Children at the New York Post 

Graduate Medical School and 

Hospital; etc.; etc. 



NEW YORK AND LONDON 

FUNK AND WAGNALLS COMPANY 

1906 



LIBRARY of CONGRESS/ 
Two CoDies Received 

JUN 1 igo6 

/nJJopyrifiht Entry 

XXc. No? 

?9 



CLASS ' 

COPY' B. 



Tft 









& 



V 



Copyright, 1906, by 

FUNK & WAGNALLS COMPANY 

(Printed in the United States of America) 



Published, May, 1906 



So 

MY WIFE 

THIS BOOK IS 

MOST AFFECTIONATELY 

DEDICATED 



PREFACE 



TTHERE are many details pertaining to 
* ventilation, clothing, and bathing which 
every mother and nurse should know and 
which she should have in a condensed man- 
ual. The physician cannot always be at hand 
to answer the many details which the modern 
mother requires, most especially if she is out 
of town or if she is traveling. Suggestions 
and advice for infant feeding in health, and 
when the stomach and bowels are out of order, 
form the most important part of this little 
work. Directions for the management of 
fever, and a guide during such diseases as 
measles, croup, skin diseases, etc., are given. 
In cases of accidents, poisoning, etc., I have 
given ample advice to be followed until medi- 
cal help can be procured. The correction of 
bad habits, and the management of rashes 

vii 



Vlll PREFACE 

have received careful consideration. Let me 
hope that the book will serve as a companion 
to the young mother and nurse for whose 
instruction it is intended. I desire to ac- 
knowledge my indebtedness to Miss Alice 
Haehnlen for many valuable suggestions. 
New York, February, 1906. 



CONTENTS 



PART I 
GENERAL HYGIENE OF THE INFANT 



CHAPTER 

I The Nursery 

The bed — ventilation- 
and toys. 



PAGE 

3 



-temperature — nursemaid, 



II 


Bathing and Care of the Navel 


9 


III 


Clothing ...... 

By day and by night — Out-of-doors. 


18 


IV 


Development and Growth 

Growth — weight — exercise — out-door life, and 
the carriage. 


26 


V 


Proper Training .... 

Bowel movements — the cry, and sleep. 


35 


VI 


Vaccination and Dentition 






(Teething) 


42 




PART II 






INFANT FEEDING 




I 


General Feeding .... 


49 


II 


Breast Feeding .... 


52 


III 


Weaning ...... 


56 


IV 


Mixed Feeding .... 


59 


V 


Artificial Feeding .... 


60 



IX 



X CONTENTS 

CHAPTER ( PAGE 

VI Bottle Feeding . . . .62 

Utensils required — care of the bottles — care of 
the nipples — how to heat milk for infant 
feeding. 

VII Home Preparation of Infant Food 64 
VIII Peptonized Milk Feeding for a Baby 

with Weak Digestion . . 67 

IX Feeding a Dyspeptic Baby . -71 

X Proprietary Infant Foods . . 73 

XI Feeding During Diarrheal Period 76 

XII Dietary for a Child from 1 to 3 

Years of Age . . . .78 

XIII Food Recipes . . . -79 

Barley water — rice water — oatmeal water — 
gruels — albumin water — nutritious lemonade 
— nutritious orangeade — junket — whey — 
beef juice — broths — weak tea — gelatin 
pudding- — custard — soft-boiled egg — toast — 
raw scraped steak. 



PART III 

MISCELLANEOUS DISEASES AND 
EMERGENCIES 



I Vomiting and Colic 
II Constipation .... 

III Malnutrition (Marasmus), Rickets 

etc. ...... 

IV Fever and Temperature 

V General Rules for Contagious Dis 

EASES ANL FEVERS 

VI Measles, Scarlet Fever, Diphtheria 

and Croup .... 
VII Whooping-Cough and Tonsillitis 



87 
91 

95 
100 

103 

105 
in 



CONTENTS XI 

CHAPTER PAGE 

VIII Skin Disease . . . . .116 

Eczema — prickly heat — chafing — chapped 
hands and face — sunburn — hives — boils — 
mosquito bites — ringworm. 

IX Accidents and Emergencies .121 

Burns — splinters — bumps and bruises — cuts — 
foreign bodies in the throat, stomach, eye, 
nose, and ear — poisoning — bleeding. 

X Ear and Eye . . . . .126 

Earache — running ears — projecting ears — 
crusted eyelids. 

XI Bad Habits, etc. .... 129 

Thumb sucking — nail biting — bed wetting — 
masturbation. 

XII Worms ...... 132 

XIII External Applications, and the 

Medicine Chest .... 134 

Index ...... 139 



PART I 

General Hygiene of the Infant 



CHAPTER I 
THE NURSERY 

IF possible the nursery should be a large 
room having plenty of fresh air and sun- 
light. Everything in the nursery should be 
washable; the walls, if possible, should be 
painted instead of papered; the furniture 
should have no upholstering; the floor should 
be of hardwood, or closely boarded and 
covered with a few rugs that may be cleaned 
with a damp cloth. 

A feather duster should never be allowed Dusting. 
in the room. Nothing should be allowed in 
the room that can not be dusted with a damp 
cloth. The screens should be covered with 
material that may be easily washed. 

The windows should have no other hang- The 
ings than oil shades, of which there should be 
a green one and a white one at each window 
to regulate the light, which should be neither 
dull nor glaring. At night, to insure proper 
repose there should be no light. With the 
modern convenience of electricity, a small 

3 



4 THE HEALTH-CARE OF THE BABY 

green glass bulb can be used when a light is 
necessary. A wax candle will answer for all 
purposes at night if electric light can not be 
used. 
The Bed. a brass or iron bed without any hangings 
should be selected. The bed should be one 
having a good woven wire mattress; it is no 
matter if the knobs and scrolls are not fancy. 
On top of this wire mattress place a heavy 
blanket folded so as to fit the bed, or a hair 
mattress. (I prefer a blanket, as this can be 
unfolded and aired daily, and occasionally 
washed.) 

Cover the mattress first with a rubber sheet, 
second a cotton sheet, third a quilted pad. 
On this pad the baby is laid and covered 
first with a cotton sheet, second with light- 
weight wool blankets and as many as are 
required for the temperature of the room. 
Down comforters may take the place of 
blankets, as they are much lighter in weight. 

The pillow should be filled with hair, never 
with feathers or down, and should never be 
more than one inch high. 

The blankets or comforters should be hung 
on the line for a good airing every few days. 
The bed should not be made as soon as the 
baby is taken up in the morning, but the bed- 



THE NURSERY 5 

clothes should be spread apart daily until 

thoroughly aired. Sheets or pads that have 

once been wet must be changed for fresh ones. 

Never put the baby in a cold bed, but see that 

the sheets are warmed by means of hot- water 

bags before the baby is placed there. 

Fresh air is of almost as much importance ventila- 
tion. 

to the baby as food. That the giving of fresh 
air to the baby is sadly neglected for fear of 
"taking cold," can be seen in everyday life 
among the majority of people with whom we 
are brought in contact. A baby confined to 
a room with hot air is far more liable to catch 
cold when taken out of doors than one ac- 
customed to be in a room having fresh, cool 
air. The nursery should be thoroughly ven- 
tilated at least twice a day. This can easily 
be done while the baby is taken out into the 
street or into another room. Fresh air should 
be admitted to the nursery from windows 
communicating with the street or yard. Air- 
shaft ventilation must never be permitted. 
If the nursery has an open fireplace fresh air 
can be admitted constantly. A windowboard 
may also be used to admit air constantly. 
This windowboard is a strip of wood five 
inches high and the width of the window. 
The lower sash is raised and the board in- 



6 THE HEALTH-CARE OF THE BABY 

serted. This makes a space between the two 
window sashes through which the air can 
gradually enter the room. 
Night Night air is fresh air and should be ad- 

mitted to the nursery. Children deprived of 
fresh air at night are more sensitive and hence 
contract cold in the head and "sniffles" more 
readily when taken out of doors. At night 
the nursery can be ventilated by having a 
window open in an adjoining room, or if the 
weather is not too cold, the window furthest 
from the baby's bed may be left open, and the 
screen properly placed to avoid any possible 
draught. Give the baby plenty of breathing 
room by placing the screen away from the 
bed, not tight up against the bed, as is so fre- 
quently done. 
Heating Most of our city houses and apartments 
Nursery. are j^g^d ^y me ans of a hot-air furnace or 
with steam heat. The best method of heat- 
ing is by means of an open fire. Gas stoves 
should never be used in the nursery. If ad- 
ditional heat is necessary during the bath, an 
oil stove should be used. 
Tem era- During the day the temperature of the 
ture. nursery should be between 65 and 70 F., 
never more. During the night it should never 
be over 65 F., and gradually reduced so that 



THE NURSERY 7 

when the baby is about one year old it will 
not be over 6o° F. 

The selection of a nurse-maid is not an easy The 

Nurse- 
matter. That it is an important matter we maid- 
can see when we consider cases of tuberculo- 
sis and syphilis that have been unquestionably 
transmitted by the nurse to the child. Do not 
select a nurse-maid who suffers with catarrh 
or throat trouble. If possible select a nurse- 
maid who has been trained in a hospital de- 
voted to the care of infants. She should be a 
woman between twenty and forty years of age, 
one that is quiet, mild-mannered, and that does 
not "know everything." Experimental feed- 
ing, as frequently tried by the nurse, is re- 
sponsible for more rickets and weak children 
than any other method of rearing children. 
The nurse-maid should wear a dress or uniform 
that may frequently be washed. She must 
take orders from the physician and mother. 
It is the mother's place to instruct the nurse- 
maid. A mother who is dependent on a 
nurse will find that fact to be a detriment to 
her child. 

In selecting toys for the baby those made Toys, 
of ivory or rubber are to be preferred. Select 
the best quality of pure rubber and avoid 
those whose colors rub off. Avoid all "woolly 



8 THE HEALTH-CARE OF THE BABY 

lambs" and "woolly dogs," as the baby is sure 
to get some of the fluff into his mouth, which 
will cause gastric disturbance. Wooden blocks 
that can be washed, not those covered with 
paper, should be given to the baby. 



CHAPTER II 
BATHING AND CARE OF THE NAVEL 

BATHING 

THE first bath given to the baby should |^ h First 
be an oil or vaselin bath. Soon after 
the baby is born the body should be anointed 
with warm olive oil or warmed vaselin. This 
oil can be applied with a large cotton wad. 
By this means we can remove the cheesy 
covering, called vernix caseosa, with which 
the baby is born. The oil bath serves the 
double purpose of cleansing the skin and 
lubricating the body so that the chilling of the 
body is prevented. An oil bath should be 
given daily until the navel cord has dried and 
fallen off. This usually happens between the 
fourth and eighth days. The first tub bath 
may now be given. Requisites for the Tub 
Bath are: A warm room, temperature 70- 
7 2 F.; papier-mache bath-tub on a low table; 
a basin of fresh warm water; two soft sponges 
or wash cloths; two large soft towels; a bath 
thermometer with wooden case ; olive oil soap 

9 



IO THE HEALTH-CARE OF THE BABY 

or Unna's superfatted soap; a powder shaker 
containing pure talcum powder; several 
toothpicks on which a little absorbent cotton 
is twisted; a soft brush and fine comb; a 
large flannel bathing apron. 
The When giving the baby a bath, see that the 

ture of temperature of the room is between 70-72° F. 

Bath and , 

Room. Place the tub where there is no possibility of 
a draught, or avoid draughts by means of 
screens. Never place the tub on the floor, 
but always on a low stand or table. For a 
very young infant have the temperature of the 
bath between 98-100° F. As the baby grows 
older, gradually lower the temperature so that 
when baby is one year old the temperature is 
between 85-90° F. Always use a bath ther- 
mometer, never guess at the temperature, as 
the water will feel very much warmer to the 
sensitive skin of the baby than to a hand ac- 
Howto customed to hot water. After everything is 
Bath. ' prepared for the bath, and the fresh clothing 
for the baby is warmed, tie on the large flan- 
nel bathing apron. Undress the baby and 
take him on your lap. Cover all but his head 
with the flannel apron. After bathing the 
face with the fresh water from the basin, soap 
the cloth and carefully wash the head and 
scalp. Dry the face and head thoroughly. 



BATHING AND CARE OF THE NAVEL II 

The entire body is now carefully bathed with 
soap and warm water from the basin. Keep 
the baby wrapped in the flannel apron as 
much as possible while this is being done. 
Now lift him gently into the fresh warm water 
in the bath-tub. Use a fresh cloth and thor- 
oughly rinse off all soap. After remaining in 
the tub for two or three minutes he should be 
lifted out of the tub and placed on the warm 
towels which have been prepared on the bed. 
Wrap the towel around him and gently pat 
him dry. Use the second towel to dry all the 
little folds of flesh, under the arms, at the 
neck, between the thighs, etc. Lift the baby 
from the damp towel on to a dry blanket, rub 
him with alcohol, and dust a little talcum 
powder on the neck, behind the ears, under 
the arms and knees, in the groin and on the 
buttocks. Wipe away the superfluous powder 
as it will only irritate the skin, especially in 
the groin where it is likely to get wet and cake. 
As baby grows older he may remain in his 
bath longer — from five to ten minutes, espe- 
cially during the summer. After the morning 
bath he should receive a dash of cold water 
over his spine. This had better be given by 
means of a large sponge saturated in cold 
water. While the baby is still seated or 



12 THE HEALTH-CARE OF THE BABY 

standing in the bath water, this saturated 
sponge should be held back of his head, the 
water squeezed out and allowed to run down 
his back. By the use of cold we contract the 
blood-vessels and prevent chilling of the sur- 
face. This plan is most admirably adapted 
for hardening the baby, thus preventing him 
from taking cold easily. 
The If the baby is a boy the foreskin should be 

Foreskin. 

pushed back every day and the parts carefully 
washed with cotton and warm water, remov- 
ing all white particles that may have collected 
there. 
The scalp. The scalp need only be washed two or 
three times a week, unless it is covered with 
greasy scales (milk crust) as is quite common ; 
then it should be washed every day and 
anointed with a little melted cocoa butter. 
If these greasy scales persist, the physician 
should be consulted. Be very careful when 
washing the scalp or removing these scales, 
as the fontanel or "soft spot" on the top of the 
head is open. Do not rub over this spot 
roughly or allow anything to fall on it or 
strike it. 
To clean After baby is dressed his nose and ears 
and Ears, should be cleaned by means of wooden 
toothpicks on which a little absorbent cotton 



BATHING AND CARE OF THE NAVEL 1 3 

is twisted, care being taken to see that the 
end is well covered. Dip the covered end of 
one of these toothpicks into a solution of boric 
acid and insert into the nose ; by gently mov- 
ing it around the nostril remove as much of 
the secretion as possible. Clean the ears in 
the same manner, but use a freshly mounted 
toothpick for each ear and nostril. 

Boric acid solution for the baby's toilet is 
made by adding a teaspoonful of boric acid 
powder to a pint of boiling water, or can be 
bought from the druggist by asking for a two 
per cent, solution of boric acid. 

Baby should receive a daily washing of his §^°^ th 
mouth with a weak solution of boric acid. 
This can be done by wrapping a piece of ab- 
sorbent cotton around a toothpick or the little 
finger. Dip this into the boric acid solution 
and gently go over the baby's gums, cheeks, 
tongue and roof of the mouth. 

When the teeth are present they should becareof 

r J the Teeth. 

kept clean. Neglect of the teeth will result in 
caries and foul breath ; particles of milk some- 
times remain between the teeth, turn acid, 
and so destroy the enamel of the teeth. Baby's 
teeth are best cleaned by means of a small 
piece of cotton dipped in a weak solution of 
listerine and water. The teeth of older chil- 



14 THE HEALTH-CARE OF THE BABY 

dren may be cleaned with a slice of lemon or 
lemon juice applied with cotton. 

The Eyes. To cleanse the eye dip a small pledget of 
cotton into a two per cent, boric acid solution. 
Hold this cotton near the eye and squeeze the 
cotton, letting a little of the solution fall on 
the eyelid. Let it remain for a few moments; 
do not attempt to open the eye as the solution 
will trickle there itself; wipe, but do not rub, 
the eye gently toward the nose with a dry 
piece of cotton, using a fresh piece of cotton 
for each eye. 

Jhe Nails if ft j s necessary to shorten the nails they 
should be cut, not bitten, off before the baby 
is bathed. After the bath any remaining 
foreign matter under the nails may be re- 
moved with a wet toothpick. 

The hair should be brushed with a soft 
camePs hair brush. 

when to It is well to give the bath just before putting 

rJcitiie tne 

Bab y- the baby to bed and before the evening feed- 
ing. It makes him sleep better and there 
is no danger of his catching cold by being 
carried about. Never give a bath directly 
after a meal or just before the baby is to be 
taken out. In the morning one hour after 
his feeding he may have a sponge bath. Dur- 
ing the summer months the baby may have a 



BATHING AND CARE OF THE NAVEL 1 5 

tub bath (one minute dip) in the morning in why Baby 

Should 

addition to his evening tub bath. There are Have a 
four channels by which impurities can be re- Dail y- 
moved from the body ; they are: i. The skin; 
2. The kidneys; 3. The intestines; 4. The 
lungs. 

To remove impurities through the skin, the 
pores of the skin must be kept open. This 
can only be attained by bathing. Besides 
cleansing the skin the bath exerts a very sooth- 
ing influence on the nerves. Very nervous 
children will appear more calm after a bath, 
so that children who are restless at night will 
be strengthened and soothed by this simple 
means. 

If the baby's skin shows a tendency to be sensitive 
red and chafed then it is advisable to use no 
soap at all, but an ordinary bath or an oat- 
meal bath made in the following manner will 
be found advantageous : 

Take between one and two pounds of oat- oatmeal 

r Bath. 

meal and sew it into a bag made of cheese- 
cloth. Place this bag in the baby's bath-tub; 
let it soak in hot water for about one half 
hour, and then add enough water to bathe 
the baby. The duration of the bath should 
be from five to ten minutes; the temperature 
of bath 95 F. 



1 6 THE HEALTH-CARE OF THE BABY 

when to Do not bathe the baby if he has an eczema 
Bathing. or a ver y reddened skin. (Read also the 
article on Eczema on a later page.) Do not 
bathe him if an eruption is present, unless the 
eruption is due to an irritation applied to the 
skin. Turpentine, mustard, and camphorated 
oil, when rubbed into the skin, will cause an 
eruption resembling scarlet fever. Under 
such conditions the bath may be used. When 
fever develops the bath may be continued, 
provided there is no eruptive disease like 
measles or scarlet fever. When baby has a 
cough or catarrhal manifestations, it is ad- 
visable to discontinue the bath for a few days. 



CARE OF THE NAVEL 

The nurse in charge of the baby must 

thoroughly wash her hands and clean her 

nails before touching the cord. 

At Birth. Dry dressings only should be used. The 

cord should be dusted with pure talcum 

powder and wrapped in several thicknesses 

of sterilized cheesecloth or clean, soft linen. 

A clean dressing should be renewed daily 

until the cord falls off. 

After the Sprinkle some talcum powder into the 

off. a s navel and cover it with several layers of cheese- 



BATHING AND CARE OF THE NAVEL 1 7 

cloth or linen, over which apply the belly- 
band. 

If proper cleanliness has not been observed, sore 
then inflammation of the navel will result. 
If such is the case, the skin surrounding the 
navel will appear reddened and an oozing or 
discharge of pus follows. The physician's 
attention must be directed to this condition, 
the neglect of which may sometimes result in 
blood-poisoning. 

When baby strains very hard to have a Rupture 
movement of the bowels a rupture of the navel Navel. 
sometimes follows. This protruding mass 
feels soft, and a distinct gurgling sound can 
be heard when it is replaced or pushed back 
by the finger. Straining during constipation 
or straining during continued diarrhea may 
cause this condition. Violent coughing spells 
such as occur in whooping-cough may also 
cause this rupture. A snug-fitting abdominal 
binder evenly placed will support the abdo- 
men and hold this rupture in place. It is 
best to consult the physician the moment the 
rupture is noticed. Until then a strip of zinc 
oxide adhesive plaster i| inches in width 
should be tightly drawn around the body 
covering the rupture. 



CHAPTER III 
CLOTHING 

THE new-born baby requires the follow- 
ing clothing: During the day, a flannel 
band; a diaper; socks; a long-sleeved shirt; 
a flannel pinning blanket; a white dress. At 
night, a flannel band; a long-sleeved shirt; 
a diaper; a flannel night-dress. 
The The flannel band should be long enough 

Band. to reach twice around the baby's body and 
should never be more than four inches in 
width. It will interfere with the breathing 
if brought up too high. It should have no 
seams or hems to cause uneven pressure, as 
it must fit snug, but not too tight. This band 
should always be closed on the left side; 
whenever possible it should be closed by 
basting with needle and thread. If the baby 
is restless and this can not always be done, 
then it may be fastened by using four of the 
smallest size safety pins. 
The Knit This flannel band should usually be dis- 

Band. J 

carded after the baby reaches the age of three 

18 



CL01HING 19 

months. When this band is discarded, a knit 
silk and wool band should be used in its place. 
This band is held in position by means of 
shoulder straps. 

The diaper should be made of soft bird's- The 

t-» i 1 • -i t i Diaper. 

eye cotton. For a very young baby it should 
be made about eighteen inches square and 
folded but once. Knitted diapers are light, 
porous and elastic and yield to all strains and 
motions of the body; they can be bought in 
the stores. I especially recommend them for 
children after they are placed in the sitting 
position. 

Never place a small folded diaper inside 
of the regular diaper; this would cause too 
much thickness between the baby's legs, and 
may cause the legs to assume a bowed appear- 
ance, especially if the bones are soft and bend 
easily. The baby should never have more 
than two thicknesses of cloth between his 
legs. To protect the skirts from the excess 
of urine, a quilted diaper pad about twelve Quilted 
inches square can be laid directly under thePad per 
baby after he is diapered, and the skirts then 
arranged over this pad. This pad should 
never be tied by means of strings around the 
baby's waist as is so often seen, as this brings 
the weight on the hips. By careful handling 



20 THE HEALTH-CARE OF THE BABY 

the pad will remain in position when the baby 
is taken in arms. Never resort to a rubber 
diaper, for sanitary reasons. 

The diaper once wet must never be dried 
and used again, for unless the baby is per- 
fectly normal the urine may contain sub- 
stances which will irritate the buttocks and 
thighs, thus causing redness and chafing. At 
times eczema will result from constant irrita- 
tion. All diapers once used should be placed 
in a covered pail and washed and boiled as 
soon as possible. They should be dried in 
the open air and sun, never in or near the 
nursery. 
The Over the band a gauze or light-weight silk 

and wool shirt with high neck and long 
sleeves is worn in summer, a second weight 
silk and wool shirt in spring and fall, and 
a third or heavier weight in winter. The 
fourth or very heavy weight shirts found in 
our stores should never be used in our climate. 
Silk and wool shirts should be used because 
they are light in weight and wash well. Woolen 
materials shrink and become hard in washing. 
A combination of silk and wool, no matter 
how often washed, remains soft, retains its 
original size and shape and gives freedom 
with every motion of the baby's body. 



CLOTHING 21 

Next comes the pinning blanket. This is The 
always made of light-weight flannel, and made Blanket. 
after the regular skirt pattern, only that it is 
left open in the back the full length of the 
skirt, thus making it more convenient in 
handling the baby, changing the diaper, etc. 
This pinning blanket may also be modeled 
after the popular " Gertrude" pattern. After 
the pinning blanket is closed, the skirt part is 
folded, and turned up at the bottom and 
pinned with several safety pins, so as to reach 
just above the hem of the dress. This will 
keep the cool air from the baby's feet and at 
the same time give him plenty of room to 
kick or move his limbs. 

When baby is put into short clothes, about The 
the age of five months, a short flannel skirt, Skirt, 
on a flannel body in winter, on a cotton body 
in summer, takes the place of the pinning 
blanket. Over the flannel petticoat mothers 
usually insist on putting a white petticoat 
because it "looks better." This is not neces- 
sary and only adds more weight to the baby's 
clothes. 

The dress, skirts, and band are slipped over The 
the infant's feet, never over its head. On 
cold days the baby should wear a dress of 
flannel or a flannel or cashmere sack over the 



22 THE HEALTH-CARE OF THE BABY 

white dress. The baby's clothes should be 
made plain, avoiding all ruffles, plaiting, and 
useless trimmings; allow [only enough ful- 
ness for comfort; select fine, soft materials, 
and when trimming is considered indispensa- 
ble, use laces instead of embroideries. 
Blankets It is advisable to have several light woolen 
wrappers, wrappers which can be quickly slipped on 
the baby whenever necessary. Knitted wool 
blankets are more serviceable than the bought 
woolen blankets for wrapping baby, as they 
are light in weight and can be more easily 
washed, more quickly dried and remain softer 
than the woven blankets. 
Inlihoel ^^ ^ eet should be covered with very 
closely knitted silk and wool socks. When 
the clothes are shortened soft moccasins or 
kid shoes and merino or silk and wool stock- 
ings take the place of the woolen socks or 
booties. 

When the baby is able to stand on his feet 
and shows signs of taking the first steps, a 
shoe with a flat, broad sole should be made to 
fit the individual child's foot as accurately as 
The possible. An inside ankle support should be 

support, fitted into the shoe. Another shoe that an- 
swers the same purpose is made with whale- 
bones fitted at the sides. Laced shoes are 



CLOTHING 23 

preferred to buttoned ones as they can be made 
to fit the foot better. 

The baby's clothes should be shortened when to 
when he begins to kick or show signs of Baby's 

& & Clothes. 

wanting to use his limbs — this is about the 
fifth month. It is not wise to make this 
change during cold weather. If the baby is 
born in July it is better to shorten the clothes 
in October, the beginning of the fourth month, 
rather than wait until November and make 
the change during very cold weather. 

The baby should always be dressed while Position 
lying on his back on a soft bed or a pillow, while 
Very little or no turning of the baby is neces- Dressed, 
sary. The band, as said before, may be 
slipped over the feet, the body gently raised 
by grasping the feet, the arms slipped through 
the shoulder straps and the band then slips 
into place without turning the baby. The 
skirts and dress are laid together and slipped 
over the legs at the same time ; after the sleeves 
are gently worked over the arms the baby is 
turned on the right side and the skirts and 
dress are closed. If a sack is required the left 
arm can be slipped into the sleeve while the 
baby is still on the right side ; one more turn- 
ing of the baby to the left side will permit the 
right arm to be slipped into the right sleeve. 



24 



THE HEALTH-CARE OF THE BABY 



When 
Com- 
fortably 
Dressed. 



When too 

Warmly 

Dressed. 



Night 
Clothing. 



Street 
Clothing. 



When the baby has on the right amount of 
clothing his limbs will be pink or the skin 
mottled. They should not be bluish, as they 
usually are when the baby is not dressed warm 
enough. In special cases, where, for example, 
heart disease exists, continued blueness of the 
limbs is found. Such cases require careful 
medical supervision. 

When the baby is too warmly dressed per- 
spiration will result. This has a weakening 
effect, besides producing a sensitive skin, which 
means less resistance and a liability to take 
cold easily. 

A baby under twelve months is put to bed 
with a shirt, a diaper, and a flannel or flannel- 
ette nightdress, which is made long enough to 
allow the hem to be gathered on a drawing- 
string. This will insure the baby's feet being 
covered even though the outer covering be 
kicked off. 

After the baby discards the diaper at night, 
night-drawers, which will be found more serv- 
iceable and comfortable, may be worn. 
These can be made of canton flannel or can 
be bought made of stockinette. 

When the baby goes out-of-doors he needs, 
in addition to the regular house clothes, a 
long woolen or wool- lined coat with shoulder 



CLOTHING 25 

cape as an extra protection; a silk cap with 
heavy lining; woolen mittens; a lace veil 
(bobbinet), which may be worn on very windy 
days or when asleep in the carriage. A 
woolen veil should never be worn, as there is 
danger of the baby swallowing some of the 
fluff. After the baby is in short clothes leg- 
gins will be necessary in cold weather. Dur- 
ing the summer a piqu6 coat and a thin lace 
cap are all that is necessary. 



CHAPTER IV 
DEVELOPMENT AND GROWTH 

THE average height of the new-born male 
is from 19 J to 20 inches (about 50 centi- 
meters); of the female from 19 J to 19! inches 
(about 48.5 centimeters). A child grows most 
rapidly during its first year. The increase 
during the first year is 5 to 6 f inches; second 
year, 2 J to 3 \ inches; third year, 2 \ to 2 § 
inches; fourth year, about 2 inches; fifth to 
sixteenth year annual increase from i| to 2 
inches ; sixteenth to seventeenth year, 1 \ inches ; 
seventeenth to twentieth year, 1 inch yearly. 

Diseases of the bones, rickets, and scrofula 
retard growth. A child should begin to walk 
at the end of twelve months. If a child when 
beginning to walk uses chiefly its toes and has 
a limping gait, more especially if symptoms 
of pain be noticed in one knee, and tender- 
ness be caused by handling the limb, the phy- 
sician should be consulted. 

The growth of hair seen on the baby's head 

at birth usually falls out during the first three 

26 



DEVELOPMENT 27 

or four weeks of life, and then a new growth 
gradually takes its place. This hair is light 
in color, but usually becomes darker as the 
baby grows older. 

During the second month the baby shows 
signs of intelligence. This is the time when 
the mother and nurse think it necessary to 
entertain the baby, but this gives more pleas- 
ure to the mother than to the baby, whose 
nervous system is very delicate. The brain is 
very active during the first year of life and 
therefore requires rest and quiet. During the 
third and fourth months the baby learns to 
hold up his head if his back is supported. 
He will learn to recognize his mother and he 
begins to smile and "coo." The first tears 
are usually seen during the third month. 
During the fourth month the baby begins to 
notice his toys. The salivary glands become 
active and drooling begins. During the sixth 
month he tries to sit up unsupported. This 
should not be encouraged or allowed until 
the seventh month and then only for a few 
moments at a time. During the seventh 
month the first tooth usually appears. Dur- 
ing the ninth and tenth months the baby at- 
tempts to lift himself up on his feet, and dur- 
ing the tenth and eleventh months he is able 



28 THE HEALTH-CARE OF THE BABY 

to stand with assistance. The first attempts 
at walking are generally made during the 
twelfth month, and at fourteen or fifteen 
months the baby as a rule is able to walk very 
well alone. The baby should never be en- 
couraged to walk; he will walk of his own 
accord when his muscles and bones are strong 
enough to support him. He begins to talk 
about the twelfth month, his first words usually 
being Mamma and Papa. The fontanel or 
"soft spot" in the baby's head should be com- 
pletely closed by the end of the eighteenth 
month, 
very The center of speech may be inactive and 

speaking, show no signs of development until the end 
of the second year. If the child is otherwise 
healthy, no alarm need be felt at this state of 
affairs. If, however, the child is backward 
in its physical development, as well as its men- 
tal development, then treatment must be 
sought to remedy this condition. 
sudden If an infant showing proper development 

speech, begins to speak, and for no apparent reason 
then stops speaking, the cause of the condi- 
tion should be carefully investigated. A child 
suffering from a severe infectious disease, like 
diphtheria, may during convalescence, de- 
velop paralysis, which might cause the sud- 



WEIGHT 29 

den cessation of speech. The neglect of 
treatment at such a time may result in perma- 
nent injury to the child. 

The baby should be weighed at regular when to 
intervals. Nothing else tells so accurately 
whether or no he is thriving. For the first year 
the baby should be weighed every week. Dur- 
ing the second year, every two or four weeks 
will be sufficient. The best time to weigh the 
baby is when he is undressed, just before his 
bath. 

He should be weighed in the same scales How to 

Weigh. 

each time. The scales must be accurate. 
Scoop scales are best adapted for young in- 
fants. When weighing the baby undress him, 
and wrap him in a small blanket and place 
him in the scoop of the scales; balance the 
scales and note the amount; then remove the 
baby and after dressing him, weigh the blanket 
in which he was wrapped; deduct the weight 
of the blanket from the total and the re- 
mainder will be the weight of the baby. 

The average healthy baby weighs from Normal 
seven to seven and one-half pounds at birth. 
A few ounces are generally lost during the 
first week. These are made up during the 
second week and then the baby should gain at 
the rate of four to eight ounces each week 



30 THE HEALTH-CARE OF THE BABY 

up to the sixth month. The gain from the 
sixth to the twelfth month is less, usually from 
two to four ounces a week. 

A healthy baby properly fed does not loose 
in weight. There are times when the baby 
will gain very slightly and probably for a few 
weeks not at all, and still be in a healthy con- 
dition. During the teething period and dur- 
ing very hot weather the baby as a rule gains 
very little in weight. 



Weight in 
Age. Pounds. 

Weight at birth 7 J 

Weight at 1 month 9 

Weight at 2 months nj 

Weight at 3 months 12J 

Weight at 4 months 13J 

Weight at 5 months 15 

Weight at 6 months i6j 

Weight at 7 months 17J 

Weight at 8 months i8J 

Weight at 9 months 19 

Weight at 10 months 19! 

Weight at 1 1 months 2o| 

Weight at end of 1 year 21 



Some babies fed on prepared infant foods 
or those foods containing a great deal of 
starch, will gain rapidly in weight. 

A normal baby usually doubles its weight 
at the end of the fifth month, and by the end 
of the first year weighs three times its weight at 
birth. Taking seven pounds as the average 



EXERCISE 31 

weight for an infant at birth, it should weigh 
fourteen pounds at the end of the fifth month 
and twenty-one pounds at the end of the first 
year. The table opposite shows the gain 
in weight of a healthy baby that was fed at 
the breast. 

For exercise, place baby on the bed, loosen Kicking 
his skirts and allow him to kick for fifteen or Exercise, 
twenty minutes. Turn him over on his stom- 
ach and let him kick in this position — this may 
be done twice a day. His clothing should be 
loose enough to permit him to use his arms 
and legs freely. He gets exercise while in his 
bath, kicking his legs and moving his arms. 
A cool sponge bath of the body chills the sur- 
face and causes the baby to draw long breaths; 
this expands the lungs and is the best form of 
pulmonary gymnastics. When the baby cries 
from temper let him alone — his lungs are ex- 
ercised by crying. 

When carrying the baby change him from 
one arm to the other so that he may learn to 
use and exercise both arms equally. 

When the baby is six months old place him Creeping. 
on a large, clean rug and permit him to roll 
and creep at will. This exercise requires no 
regulation except precautions against dan- 
gerous places. 



32 



THE HEALTH-CARE OF THE BABY 



Walking. 



Baby's 

First 

Outings. 



Do not put the baby on his feet. When 
he can pull himself up on his feet by his 
own effort, it will be time to encourage him 
to make the effort to stand and walk. 
Later on, walking will be the best out-door 
exercise. 

If the baby is born in summer and per- 
fectly normal, he should be given his first 
outing when eight or ten days old. If born 
in winter he must be gradually accustomed 
to out-door life. This is best done by dressing 
him in cap and coat in addition to his house 
clothes and placing him in his carriage in 
the nursery. Open the windows from the 
top, close all doors so there is no draught and 
wheel the baby back and forth for an hour 
or more. This method of giving fresh air can 
also be employed when the baby is older and 
the streets are wet or when very sharp winds 
are blowing. When the baby is two months 
old, he may be taken out in dry, cold weather. 
Begin by letting him stay out for an hour or 
two in the warmest part of the day. Grad- 
ually increase the length of time from week 
to week until the baby is accustomed to out- 
door air, when he can remain for several 
hours at a time each nice, dry day. In sum- 
mer the baby may remain out doors until 5 



THE CARRIAGE 33 

o'clock and in the winter until 3 o'clock if 
the air is clear and dry. 

In summer the baby should be taken into 
the house or in the shade during the hottest 
part of the day, from 12 noon to 3 p. m. 

Select a carriage that is strongly built, that The m 
has good springs, wheels with rubber tires, 
and a top that can be made to fit tightly about 
the head of the carriage. This top is espe- 
cially valuable in winter, as it keeps off all 
winds. Separate tops of linen can be bought 
for use during the summer. These tops, 
whenever possible, should be lined in green, 
as this color is the least trying to the baby's 
eyes. In winter the carriage should contain 
a hair pillow covering the bottom of the car- 
riage and another small, flat, hair pillow for 
the baby's head. Over the pillow should be 
placed a knit wool blanket. The baby should 
be placed on this blanket which then should 
be carefully wrapped around him. Another 
wool blanket or afghan should be placed 
over the baby and tucked well in at the sides 
and foot of the carriage. Over this a fur robe 
should be placed in very cold weather. In 
summer cotton covers take the place of the 
wool blankets. When the baby is still very 
young it is better for the nurse to stay on 



34 THE HEALTH-CARE OF THE BABY 

one block so as to avoid jars at crossings 
or curbs. When it is necessary to take the 
carriage over curbs, the hind wheels should 
be gently let down first. This avoids that 
sudden forward jar of the baby and leaves 
him in a comfortable position. 

As the baby grows older and is able to sit 
up, or about the ninth month, the seats which 
are bought with the carriage may be used 
and arranged so as to give him the proper 
position. 
Feeding The best place to feed the baby is in the 

in the * J 

carriage, house, although I frequently permit a baby 
to be fed, in the carriage, out of doors during 
the summer. 
sleeping There is no objection to the baby's sleeping 
carriage. w hen in the street. There is no more danger 
of his taking cold while asleep than when 
awake. We invariably find those children 
who sleep out of doors less prone to take cold. 
See that baby is dressed warm and placed in 
the sunshine with his face and eyes protected 
from the sun and wind, and he will sleep with 
comfort and advantage. 



CHAPTER V 
PROPER TRAINING 

FROM earliest infancy it is advisable to Resting, 
train the baby. He should be given the 
breast, and after nursing or feeding from the 
bottle, be laid in his bed. If this habit is 
begun early a regular habit of resting can be 
formed. 

When baby is three months old he can be The 
taught to use the commode. He should be 
placed on a small chamber held in the nurse's 
lap. As he grows older and strong enough 
to support his back he may be placed on his 
chair or commode. The best time to have 
baby's bowels move is in the evening before 
his bath or evening feeding. As baby grows 
older his bowels will move with less effort 
after his feeding, but this should not be en- 
couraged while he is young, as he is liable to 
regurgitate his food. If baby makes no at- 
tempt to move his bowels when placed on the 
commode, then a small soap stick, or a gluten 
or glycerin suppository, should be inserted 

35 



36 THE HEALTH-CARE OF THE BABY 

into the rectum. By this means we direct the 
baby's attention to the reason of his being 
placed on the vessel. Such treatment may 
be repeated daily for weeks or until baby's 
bowels move unaided. 
sanitary Each child should have his own vessel or 

Nursery 

seat. hi s own sea t as a sanitary measure. These 
sanitary wooden seats can be bought at any 
of the large department stores of New York 
City. They can be laid on any vessel and 
prevent the child's body from coming in con- 
tact with the vessel. As they are small in size 
they are adapted for the young infant as well 
as the older child. 

The What is possible with the bowels can be 

accomplished with the bladder. If the mother 
or nurse will place the infant on a vessel 
every three or four hours he will gradually 
learn to hold his urine until such time. He 
should be placed on the vessel immediately 
on awakening, be it night or day. Children 
invariably empty the bladder on awakening. 

Normal At birth, the baby may normally have from 

Move- _ ' J \ r t 

ments. three to four movements in twenty-four hours. 
As he grows older one or two movements a day 
will be sufficient. While the baby is fed on 
a milk diet his stool should be yellowish in 
color, smeary or pasty-like in consistency, and 



PROPER TRAINING 37 

the smell should be acid, but not disagreeable. 
As soon as an exclusive diet is changed to a 
mixed diet, the stools lose the yellow color 
and become darker, and resemble more those 
of an adult, though remaining softer and 
thinner throughout infancy. 

Mucus is always present in all healthy Mucus, 
stools, but is so well mixed that it does not 
appear as mucus to the naked eye. Any ap- 
pearance, therefore, of mucus easily visible 
should be regarded as abnormal. 

Abnormal stools requiring treatment are Abnormal 

1 ° Move- 

these: Greenish stools resembling spinach ; ments - 
greenish stools containing small, white parti- 
cles; brownish stools having a very offensive 
odor; thin, brownish stools resembling muddy 
water, passed with considerable flatus (gas); 
dry, white or light gray stools; stools with 
jelly-like masses or long shreds of mucus; 
stools passed in hard, dry balls; stools mixed 
with blood. 
To develop an infant's brain the nervous Hygiene 

• i i r i . of the 

system requires quiet but cheerful surround- Nervous 

J ^1 M System. 

ings. Useless excitement is harmful. To 
take the baby and handle him> like a toy is 
wrong. I have seen infants taken up from a 
soun dsleep to display the "talent" that some 
one has taught them. Nothing is more harm- 



38 THE HEALTH CARE OF THE BABY 

ful than to have the mother compel her infant 
to display various tricks during its feeding. 
While this is a gratification to the friends, it 
certainly is detrimental to the infant's brain 
and nervous system. 

crying. A certain amount of crying is necessary for 

the baby if he is to be healthy and strong, for 
this is the way he exercises his lungs and sends 
the blood to the extremities. 

This normal cry is loud and strong and 
baby may indulge in it frequently; even 
though he gets red in the face this cry is health- 
ful. A careful and observing mother will 
soon learn to know this cry from the cry of 
pain, hunger or discomfort. 

causes. The baby may cry because he is hungry, or 

thirsty; his napkin may be wet; he may be 
frightened or sleepy; his clothing may be un- 
comfortable; he may be tired lying in one 
position, or he may be crying from temper 
and want to be indulged. 

When the baby cries see that he is com- 
fortable, that the napkin is not wet, that the 
hands and feet are warm, that the clothes are 
smooth under him, that no pins are pricking 
him and change his position. 

Due to If he is crying from colic the cry is strong, 

sharp, and spasmodic and often accompanied 



cry 39 

by a drawing up of the legs and a contraction 
of the features, 

The cry from earache is a continuous whine Due to 
and often the hand is brought toward the 
head. 

The cry of hunger is a continuous fretful Due to 

■ u Hunger. 

sound, heard soon after feeding or some time 
before the next meal is due, and is usually 
accompanied by the sucking of the thumb or 
fingers. 

When the baby is very ill or weak the cry Due to 
will be low or moaning. 

The cry of temper is loud and strong and is 
accompanied by kicking and stiffening of the 
body. It can easily be distinguished from 
other cries, for when baby gets what he wants 
he immediately stops. This cry of temper 
should never be given in to or the mother will 
regret it later on. The training can not be- 
gin too early. When the baby cries from 
fright he should be taken up and comforted 
and as soon as quieted put back on his bed 
again. 

When the baby cries and all causes but 
temper have been eliminated, then let him 
"cry it out," even if he cries an hour. The 
second struggle will not last so long. The 
third will be still shorter. If the abdominal 



40 THE HEALTH-CARE OF THE BABY 

band is properly applied no rupture can re- 
sult from this crying. 

In cases of habitual crying it is better to 
get the opinion of a physician as to the cause 
before subjecting the baby to too rigid disci- 
pline. 

sleep. A new-born baby sleeps about nine-tenths 

of the time. The sleeping time gradually 
diminishes and when the baby is five months 
old he usually sleeps all night and requires a 
long nap of two or three hours in the morning, 
and another of about one hour in the after- 
noon. The healthy baby sleeps with his 
mouth closed, the nostrils can be seen dilating 
gently and the chest moving slightly and regu- 
larly. The baby should never perspire while 
sleeping but the skin should remain warm. 

Proper The baby should be put to bed while awake. 

He should first be fed, made comfortable and 
the room should be darkened. He should 
neither be rocked nor sung to sleep; if left to 
himself will soon learn to fall asleep quietly. 
He should be put to bed no later than six 
o'clock, and should continue his afternoon 
nap until four years old or longer. 

causes of Disturbed sleep or sleeplessness is usually 

Disturbed . «. .,. V • * i i 

sleep. caused by improper feeding, and m the bottle- 
fed infant by over-feeding or too frequent 



PROPER TRAINING 41 

feeding. Intestinal indigestion and colic are 
the most frequent causes. Discover the cause 
and remove the disturbance yourself if pos- 
sible; failing to do so consult a physician, as 
the trouble may be due to large tonsils, ade- 
noids, spine or hip disease, chronic joint 
pains, earache or toothache. See that the 
baby's feet are warm. Do not give him too 
much clothing. Give him plenty of fresh air 
in the room. Do not excite him with a new 
toy or romping play, and do not arouse fear 
before putting him to bed. Do not use sooth- 
ing sirups or other medicines. 

When the baby is put to sleep his hands Bad 
must always be outside of the blanket or bed 
clothing. Bad habits are easily acquired, es- 
pecially so if the genital parts are unclean. 
Any itching may cause a desire to scratch, 
later on, this may lead to constant fumbling 
and if this latter is not corrected we may find 
that our baby is addicted to one of the worst 
habits found in infants or children— namely, 
masturbation. 



CHAPTER VI 
VACCINATION AND DENTITION (TEETHING) 

TO prevent a child from taking smallpox 
it should be vaccinated. All infants over 
two months old may be vaccinated. If small- 
pox exists in a locality or if an infant has 
been exposed, he should be vaccinated im- 
mediately. 

No mother or nurse should attempt to vac- 
cinate a baby; a physician should always be 
called. With care and cleanliness there is 
little or no danger of complication; on the 
other hand if the slightest amount of dirt 
from a finger nail or any other contamination 
is introduced into the wound, a child may 
contract erysipelas, which may lead to blood- 
poisoning and death. Five to seven days 
after vaccination, inflammation or redness 
around the vaccinated area will be noticed. 
This is the natural course "of taking." If 
this redness spreads and the skin is swollen 
and tense the physician will usually prescribe 
a cool, moist dressing of lead water or a one 

42 



TEETHING 43 

per cent, boric acid solution. The reddened 
surface is to be covered with gauze moistened 
with one of these solutions until the inflam- 
mation subsides; this usually takes two or 
three days. 

When the baby is about four months old Drooling, 
the flow of saliva usually begins, or is very 
much increased, so that a bib must be pro- 
vided. This "slobbering," as it is famili- 
arly called, is not a sign that the teeth are 
trying to push their way through the gums, 
but simply signalizes the development of the 
salivary glands and the further development 
of the function of digestion. 

Many mothers and nurses regard the teeth- Dentition. 
ing period as a time to be dreaded and a 
time when the baby is sure to be sick. This 
is a mistake. It is perfectly natural for the 
baby to have teeth and there is nothing what- 
soever to fear from the process. In a nor- 
mal baby the teeth usually appear between 
the seventh and tenth months. The first teeth 
are known as the milk teeth and are twenty 
in number. The following table will show the 
usual rule followed by normal dentition in 
the average baby: 

19 I 11 1 i3 I 5 1 3 1 4 1 6 I 14 I 9 I 17 

20 I 12 I 15 I 7 I 1 I 2 I 8 I 16 I 10 I 18 



44 THE HEALTH-CARE OF THE BABY 

i and 2 are the lower incisors, usually first 
teeth; then follow 3 and 4, the upper inci- 
sors. Normal children usually teeth in pairs 
and not singly, whereas rachitic children 
usually have an eruption of single teeth. As 
a rule there is a lapse of from three to twelve 
weeks between the appearance of each group. 
Some infants do not show teeth before the end 
of the first year. This is usually due to the 
fact that they are not well nourished. The 
physician should be consulted for a change 
of diet. Infants reared by bottle-feeding do 
not cut teeth as early as those nourished by 
healthy breast-milk, although rachitic infants 
sometimes teeth very early. 

The restlessness, loss of appetite, slight 
fever and putting of fingers in the mouth so 
frequently attributed to teething, are more 
often due to faulty feeding. When the gums 
are very red and swollen and baby seems really 
to suffer, ask the doctor to examine the gums 
and he will order a cooling lotion or lance the 
gums if necessary. A pledget of cotton 
wrapped in a piece of clean linen and dipped 
in a solution of listerine and water (1 part of 
listerine to 25 parts of water) if laid on the 
baby's gums is very soothing. Frequent sips 
of cool water are comforting to the baby if 



TEETHING 45 

the gums are hot. If the baby is comforted 
by biting on a hard substance, a piece of 
zwieback is preferable to the rubber or ivory 
ring so commonly used. If the baby's vital- 
ity seems lowered during the teething period, 
which is shown by slight fever, restlessness, 
undigested food in the stools or vomiting, then 
a weaker food should be given. If the baby 
is breast-fed give him one or two ounces of 
filtered water before each nursing and reduce 
the length of nursing five minutes. If bottle- 
fed, take from each bottle one or two ounces 
of milk and add the same amount of filtered 
water. When all signs of restlessness have 
disappeared the food can gradually be strength- 
ened. The milk teeth remain until the child 
is about six years old, when the permanent 
teeth appear. 



PART II 

Infant Feeding 



CHAPTER I 
GENERAL FEEDING 

EACH baby is a law unto itself, and its 
individual wants must be studied. One 
baby will gain on the same mixture on which 
another will lose weight. The proof of the 
proper assimilation of food in any and every 
infant will be the following: An infant must 
appear satisfied after taking its bottle. There 
should be no vomiting or severe colicky pains. 
The bowels must move (unaided) at least 
once or twice in every twenty-four hours. The 
stools should be yellowish- white, and medium 
soft. The infant should sleep from four to 
eight hours during the night without awaken- 
ing. 

The weight must be taken regularly once 
a week. If an infant thrives it should gain 
from four to eight ounces every week, until the 
sixth month after which time it should gain 
from two to four ounces each week. If the 
weight shows no increase by all means con- 

49 



50 THE HEALTH-CARE OF THE BABY 

suit your physician that he may give more 
substantial food. 

The natural method of feeding a baby is 
by means of the human breast. If this were 
not so then every woman would simply pass 
through her period of pregnancy and the 
breasts would not secrete milk. Breast milk 
contains in addition to nourishment certain 
antitoxic bodies. These substances usually 
prevent a child from taking the acute infectious 
diseases. To produce this immunity from 
disease is in itself sufficient compensation for 
the arduous duties demanded of a nursing 
mother. 

There are times when the breast milk is de- 
ficient in quantity. At such times we should 
always make use of what little breast milk 
is present and supply the deficiency by giving 
the bottle. 
Water. Every child, young or old, must receive 

water several times a day. It will aid ma- 
terially in clearing the mouth and gums and 
in quenching thirst. An infant up to the first 
month should receive several teaspoonfuls of 
plain filtered water either immediately after 
nursing or feeding or as soon after feeding 
as possible. It is not necessary to awaken 
the child in order to give it a drink. If it is 



i--^ 



GENERAL FEEDING 5 1 

not time for feeding and the infant is restless, 
a few spoonfuls of cool water will frequently 
quiet it. When we desire to modify consti- 
pation, then water will be a most important 
factor, especially so when large, cheesy curds 
are found in the stool. 



CHAPTER II 
BREAST FEEDING 

THE first three or four days after birth 
require special feeding methods : 
The first substance secreted in the breasts 
is known as colostrum. This is thinner than 
milk and very scant. The exhaustion of the 
mother beside the normal deficient quantity 
of food in the breasts, demands long inter- 
vals of rest; thus for the first three days put- 
ting the baby to the breast once every three 
to six hours would be sufficient. If, how- 
ever, the supply of milk is ample then we can 
follow the table on page 53 and feed the baby 
every two hours. 
interval During the first month the baby should be 

During 

Day. fed every two hours during the day, never 
oftener; and during the second month every 
two and one-half to three hours. The baby 
may be taken from his sleep during the day 
to be nursed. 

Do not disturb the baby from his sleep at 
night to be nursed. Let him rest as long as 

52 



BREAST FEEDING 



53 



From 


At 










Birth 


i Month 










Until i 


Until 2 


2 to 4 


4 to 6 


6 to 9 


9 Months 


Month 


Months 


Months 


Months 


Months 


Until 1 


Old. 


Old. 


Old. 


Old. 


Old. 


year Old. 


6 A. M. 


6 A. M. 


6 A. M. 


6 A. M. 


6 A. M. 


6 A. M. 


8 A. M. 


8 A. M. 


8:30 A. M. 


9 A. M. 


9:30 A. M. 


IO A. M. 


IO A. M. 


IO A. M. 


II A. M. 


12 Noon 


I P. M. 


2 P. M. 


12 Noon 


12 Noon 


I 130 P. M. 


3 p. M. 


4:30 P. M. 


6 P. M. 


2 P. M. 


2 P. M. 


4 P. M. 


6 P. M. 


8 P. M. 


IO P. M. 


4 P. M. 


4 P. M. 


6:30 P. M. 


9 P. M. 


12 Mid- 




6 P. M. 


6 P. M. 


9 P. M. 


12 Mid- 


night. 




8 P. M. 


8 P. M. 


12 Mid- 


night. 






IO P. M. 


12 Mid- 


night. 








12 Mid- 


night. 










night. 


3 A. M. 










2 A. M. 













he appears satisfied. This applies to healthy 
infants only. In sickness special feeding rules 
are required. If the baby thrives and gains in 
weight, it is better for both mother and baby 
to have an interval of rest and skip a nursing 
or two after midnight. If the baby is restless 
during this interval, change his position and give 
him one or two teaspoonfuls of boiled water. 

The mother or wet-nurse should always How to 

• 1 i m • iii 1 Hold the 

sit upright while nursing the baby, be it at Baby 
night or during the day. If the baby is Nursin s- 
nursing from the left breast, he should be 
held on the left arm while the right hand 
presses the breast away from the baby's nose, 
but without pulling the nipple from his mouth. 
This will give him plenty of air to breathe so 
that he must not let go of the nipple to breathe. 



54 THE HEALTH-CARE OF THE BABY 

When there is nasal obstruction such as ca- 
tarrh, or when post-nasal obstruction exists, 
such as adenoids, then an infant will let go 
of the nipple in order to draw a breath. 
L . e $? th . No infant should nurse longer than twenty 

of Nursing ° J 

Act - minutes, whereas frequently ten or fifteen 

minutes will suffice. Do not allow the baby 
to fall asleep while nursing. If this is allowed 
he will not get all the nourishment he should 
have. Light taps on the cheek of the baby 
will waken him, or the withdrawal of the 
nipple from his mouth will frequently arouse 
him to continue nursing. If, however, he 
will not renew his nursing, and has already 
nursed ten minutes, then the sleep should not 
be disturbed. 

Do not allow him to take his meal too 
rapidly as he is liable to have an attack of 
hiccup or to regurgitate his food. If the 
baby nurses too rapidly withdraw the nipple 
from his mouth for a few seconds. This may 
be done every three or four minutes. 

As a rule the baby should nurse from but 
one breast at each meal, if, however, there 
is not enough milk in one breast, then both 
breasts may be given. 

Diet of a A nursing woman should have three meals 

Nursing ° 

Woman. a (jay. These meals should be simple but 



BREAST FEEDING 55 

nutritious and mostly liquid. Meat should 
be taken only once a day. Milk, eggs, cereals 
and soups should form the principal part of 
the diet. For thirst, cool, filtered water or 
alkaline waters, like seltzer or apollinaris, 
should be taken. 
If the milk is scanty, the flow can be stimu- scanty 

Milk. 

lated by drinking a cup of hot broth, weak 
tea, cocoa, milk or gruel several minutes be- 
fore putting baby to the breast. Foods to Food 

r & J Prohibited. 

be avoided by a nursing woman, are: Onions, 
garlic, cabbage, ethereal oils and sour fruits. 

The return of menstruation is no contra- Menstru- 

!• . * . - . ation. 

indication to the continuation of nursing. 
In nearly all cases the quality of milk will be 
affected to such a degree as to cause slight 
disturbances of digestion, such as restlessness 
or colic, or some bowel derangement. If the 
baby continues to gain in weight nursing may 
be continued. If there is too much distur- 
bance, diluted cows' milk should be given 
during the first two or three days of men- 
struation. 

No woman should attempt to nurse a baby constitu- 

1 tional 

who is not sure of her physical condition. Disease. 
Tuberculosis, hereditary nervous troubles, 
epilepsy, syphilis and all chronic disorders 
and diseases would prevent proper nursing. 



CHAPTER III 
WEANING 

BY weaning a breast-fed baby we mean 
gradually taking from him the breast- 
milk by which he has been nourished since 
birth, and giving him cows' milk and other 
forms of nourishment. 

By weaning a bottle-fed baby we mean 
gradually substituting for all cows' milk other 
nourishment such as raw eggs, soups, broths, 
and gruels. 

A normal baby is usually weaned between 
the eighth and tenth months. In some in- 
stances it is advisable to begin earlier, for 
example, when there is a deficiency in the 
quantity of breast milk owing to the ill health 
of the mother. Sometimes there are reasons 
why the baby should be nursed twelve months 
and longer so that it should always be left to 
the judgment of the physician when the baby 
would be weaned. 

My rule has been not to wean during the 

56 



WEANING 57 

summer months, although it is imperative to 
do so if the infant's mother becomes preg- 
nant. Weaning should not be attempted sud- 
denly. It is better to commence gradually 
by withdrawing the breast in the morning and 
substituting a bottle for that meal. Follow- 
ing this meal we can again nurse the baby at 
the breast for two feedings, and substitute a 
bottle for its fourth meal. 



8:00 a. m Bottle 

1 1 .-30 a. m Breast 

3 :oo p. m Breast 

6:30 p. m Bottle 

10 :oo p. m Breast 



Care must be exercised in' making this 
change of diet, as the slightest error in over- 
feeding or too frequent feeding will be re- 
warded by a severe attack of dyspepsia and 
the usual gastric disturbances, such as vom- 
iting and fermentation in the stomach, causing 
diarrhea and colic. 

If baby has been taught from birth to drink 
water from a bottle there should be no trouble 
while weaning him in having him drink his 
milk from the bottle. If it is impossible to 
make him drink from a bottle feed him from 
a spoon or let him drink from a cup. Some 
babies learn to drink from a cup when six or 



58 THE HEALTH-CARE OF THE BABY 

seven months old. It is better to have a 
strange nurse feed baby while weaning him 
and keep the mother or wet nurse away so 
he can not see the breast and be reminded of 
the breast feeding. 



CHAPTER IV 
MIXED FEEDING 

WHEN the breast-milk is of good quality, 
but the quantity is deficient, and the 
baby does not thrive and seems to cry from 
hunger, it is necessary to give him some addi- 
tional food. This is usually done by giving 
baby alternate feedings of breast-milk and 
cows' milk. 

The mother or wet-nurse should try to im- 
prove both quality and quantity of her breast- 
milk by building up her general condition. 
Frequently a subnormal or anemic condition 
requires an iron tonic. In other cases a day's 
outing to the country or seashore, with mode- 
rate exercise will stimulate the flow of milk. 

As cows' milk is more difficult to digest than 
breast-milk, it must be given well diluted; 
therefore, give the baby the amount in the 
formula provided for a baby who is one month 
younger. For example: If the baby is four 
months old when you start the mixed feeding, 
give him of the formula of cows' milk that a 
baby three months old would receive and 
gradually increase until the formula for a 
baby of his age is given. 

59 



Milk. 



A 



CHAPTER V 
ARTIFICIAL FEEDING 

LL American mothers cannot nurse their 
infants. A sick mother, a tuberculous 
mother, or a very nervous mother is frequently 
prevented from nursing her baby through her 
systemic weakness. In some instances human 
milk may be necessary to save the life of a 
weak infant or one that has been improperly 
managed. A wet nurse can be secured and it 
is in many cases a life-saving substitute. The 
large majority of American mothers resort to 
the usual method of artificial feeding by using 
cows' milk adapted for the age and require- 
ments of the infant's digestion. 
cows' The best cows' milk for infant feeding is 

sold in New York City at milk dairies under 
the name of certified or guaranteed milk. 
When certified milk can be obtained, then we 
have reached as near perfection as is possible 
to-day under strict municipal control. It is 
not necessary to sterilize or even pasteurize 
such milk, if normal conditions exist in the 

60 



ARTIFICIAL FEEDING 6 1 

infant. In special instances it may be nec- 
essary to use steamed milk, but this must 
be used only on the advice of the physician. 

Milk for baby's feeding should be kept near to p re - 
the ice in a separate compartment of the re- for Feed- 
frigerator, or better still a nursery refrigerator, 
in which nothing but baby's food is kept, 
should be used. 



CHAPTER VI 
BOTTLE FEEDING 

Re ei Srld TPHE following utensils are required for the 
A modification of milk at home: A two- 
quart pitcher; funnel, (glass or porcelain); 
one large spoon; one dozen 4-ounce bottles, 
(later 8-ounce bottles); one dozen anti-colic 
nipples; one box non- absorbent cotton; one 
large saucepan (for heating milk); one high 
saucepan (for warming bottles before feed- 
ing); one dairy, or pasteurizing thermome- 
ter. 

The The long, round feeding-bottle is the best 

of all feeding-bottles. It is smooth on the 
inside, has no corners or angles, and can be 
easily cleaned. On the outside the graduated 
ounces are marked. 

care of As soon as baby has emptied the bottle it 

the Bottles 

and , should be cleaned with a bottle brush in clear 

Nipples. 

hot water, then filled with fresh water and 
set aside. In the morning before the day's 
food is prepared all the bottles should be 
boiled in a solution of baking soda and water, 

62 



BOTTLE FEEDING 63 

two teaspoonfuls of soda to one quart of 
water. The bottles should then be rinsed 
thoroughly in clear boiled water. 

The nipples should be cleaned in the same 
way as the bottles and when not in use should 
be placed in a covered jar in cold water, to 
which a pinch of salt has been added. 

When the source of the milk is unknown How to 

Heat 

and we are not familiar with dairy methods, Milk - 
the safest plan is to heat the milk in a double 
boiler until the steam rises, and continue heat- 
ing at this same temperature for five minutes. 
We can also subject the milk to the steaming 
process by using a pasteurizer and steaming 
the milk about fifteen minutes. Milk should 
never be sterilized or boiled. 

The first evil result noticed while using Evils of 
sterilized milk is that children so fed are con- tion. 
stipated. Prolonged use of sterilized milk re- 
sults in rickets. There are many cases of 
scurvy that can be traced to a long-continued 
use of sterilized milk. 



CHAPTER VII 
HOME PREPARATION OF INFANT FOOD 

Feeding A CHILD in § ood health, with excellent 
Normal ^"^ digestion, and normal stools, may. be fed 
Baby. on m jj^ diluted with rice water. If a ten- 
dency to constipation exists then oatmeal 
water instead of rice water should be used. 
My plan has been to order the milk diluted 
with rice water on one day, and oatmeal water 
on the following day. In summer if a ten- 
dency to loose bowels is noted, then milk di- 
luted with rice or barley water should be fed. 
stomach No set rule can be given for all infants. 

v^apacity. 

Each infant's requirements must be studied. 
The size of the stomach varies in infants. 
The stomach capacity of one infant may be 
six ounces at the age of two months, while 
another equally healthy infant will have a 
capacity of and be satisfied with four ounces 
at one feeding. These individual peculiari- 
ties must be taken into consideration when es- 
timating the quantity of food for each meal. 

64 



INFANT FOOD 65 

Formula No. i (for an infant from birth Food for 

, the First 

to one month) : Month. 

Raw cows' milk 4 ounces 

Rice water * 16 ounces 

Granulated sugar 1 ounce 

(2 level tablespoons) 
Divide into 10 bottles and feed every 2 hours. 

Formula No. 2 (for an infant from one to Food for 

1 v the 

two months): second 

7 Month. 

Raw cows' milk 7 ounces 

Rice water 20 ounces 

Granulated sugar ij ounces 

(or 3 level tablespoons) 
Divide into 8 bottles, each bottle con- 
taining about 3 ounces, and feed every two 
and one-half hours. 

Formula No. 3 (for an infant two to four Food for 

, , , x the Third 

months old) : Month. 

Raw cows' milk 12 ounces 

Rice water 23 ounces 

Granulated sugar 1 J ounces 

(or 2 tablespoons and one teaspoon) 
Divide into 7 bottles, containing about 
5 ounces, and feed every three hours. 

Formula No. 4 (for an infant from four to Food for 

- „ the Fourth 

six months) : and Fifth 

Months. 

Raw cows' milk 22 ounces 

Rice water 20 ounces 

Granulated sugar 1 J ounces 

(or 3 tablespoons) 
Divide into 7 bottles, each bottle con- 
taining about 5 J ounces, and feed every 
three hours. 

1 For making rice water, barley water and other diluents, see 
the chapter on Food Recipes. Page 79- 



66 THE HEALTH-CARE OF THE BABY 



Food for 

the Sixth, 

Seventh 

and 

Eighth 

Months. 



Formula No. 5 (for an infant six to nine 
months old) : 

Raw cows' milk 28 ounces 

Rice water 12 ounces 

Granulated sugar 1$ ounces 

(or 3 tablespoons and 1 teaspoon) 
Divide into 5 bottles, each bottle con- 
taining about 8 ounces, and feed every 
three and one-half hours. 



Food for 

the Ninth, 

Tenth, 

Eleventh 

and 

Twelfth 

Months. 



Formula No. 6 (for an infant from nine to 
twelve months) : 

Raw cows' milk 27 ounces 

Rice water 5 ounces 

Granulated sugar if ounces 

(or 3 tablespoons and 1 teaspoon) 
Divide into 4 bottles, each bottle con- 
taining 8 ounces, and feed every four hours. 

Dissolve the sugar in the hot rice water 
and add the cold raw milk. Fill and cotton 
stopper the bottles and place in the refrig- 
erator but not on the ice. At feeding time 
warm to feeding temperature by placing the 
bottle in hot water, then remove the cotton 
stopper and draw on the nipple. 



CHAPTER VIII 

PEPTONIZED MILK FEEDING 

(Predigested Milk for a Baby with Weak 
Digestion) 

WHEN cheesy curds (known as the pro 
teid) are found in the stool as white 
particles of cheese, then the milk formula is 
too rich and must be still more diluted. If 
two ounces of milk and two ounces of water 
have been given and curds are still found in 
the stool, then three ounces of water and one 
ounce of milk should be given. When we 
add a peptonizing powder, also known as a 
digestive agent, to the milk, we can modify 
the curd by partially digesting it. 

Peptonizing powders are digestive agents Peptoniz- 

ing 

sold in glass tubes or in tablet form. They Powders, 
are composed of pancreatin and bicarbonate 
of soda. Another predigesting powder sold in 
drug stores is known by the name of pepto- 
genic milk powder. . 

The contents of a peptonizing tube should How to 
be added to a tablespoonf ul of cold water, and 

67 



68 THE HEALTH-CARE OF THE BABY 

a quart of cold milk slowly added. Place 
this bottle of milk containing the powder in 
a kettle of warm water, temperature about 
no° F, leaving it there for ten minutes. 
This peptonizing powder will partially predi- 
gest the milk. The milk must then quickly 
be brought to the boiling point, and placed 
in a cool place. When this method is used 
the milk does not change in taste. 
To Avoid When milk is subjected to peptonization 

the Bitter e , _ / , , . .« 

Taste. for several hours, an intensely bitter taste will 
result. To avoid this the digestive ferment 
should be killed by bringing the milk rapidly 
to a boil after it has peptonized ten minutes. 
How to To one quart of milk add the contents of 
tonized p " one peptonizing tube. Prepare as already 
stated. At feeding time pour off the required 
quantity and heat to the feeding temperature. 
A large bottle of peptonized milk can be pre- 
pared each morning. It should be kept in 
the refrigerator but not on the ice. Pep- 
tonized milk must be freshly prepared each 
day. 
indigestion A curded stool containing white, cheesy 
g h eesy particles is usually found in dyspeptic dis- 
orders affecting the stomach and bowels. 
When peptonized milk has been used such 
curds must disappear and the stool assume 



PEPTONIZED MILK 69 

a yellowish condition. When improvement 
is noted the use of the peptonized milk should 
be continued for several months, so that the 
weakened stomach and intestines may be re- 
stored to their normal, healthy state. If im- 
provement is not noted and curds continue to 
appear in the stool, then a complete change 
of food must be made. Milk in every form 
must be stopped. This will give the stomach 
a complete rest. As a substitute we can feed 
sweetened rice w r ater or barley water, to which 
the white of a raw egg is added. Such feeding 
must be continued for several days but only 
under the guidance of a physician. 

When cows' milk disagrees in spite of being p ep to- 
diluted with plain water, rice water, barley Miik 

r ' ; J Powder. 

water or oatmeal water as previously men- 
tioned, then the addition of peptogenic milk 
powder will alter the ingredients of the milk 
and render it more digestible. 

The screw cap on the peptogenic milk bot- 
tle is also a measure. To an eight-ounce 
bottle of raw milk slowly add with constant 
stirring, one-half measure (screw-cap) of pep- 
togenic powder, heat slowly for ten minutes 
over a small flame or to a temperature of 
ii5°F; then cool to feeding temperature. 
A more rapid method and one preferred by 



70 THE HEALTH-CARE OF THE BABY 

me is as follows: Take of raw milk, 2 ounces; 
hot water, 2 ounces; peptogenic milk powder, 
\ measure. Dissolve the peptogenic powder 
in the hot water, add the raw milk, heat to 
feeding temperature and feed. By this pro- 
cess each bottle is prepared separately. The 
milk does not acquire a bitter taste and the 
curd is partially digested, which is a decided 
necessity for the weak stomach of an infant. 



CHAPTER IX 
FEEDING A DYSPEPTIC BABY 

IF the baby's stool contains curds or green- 
ish masses and if the baby is restless at 
night and colicky by day, then the following 
feeding will be advisable : Take of raw milk, 4 
ounces; rice water, 4 ounces, and peptogenic 
milk powder, J measure. Heat slowly with 
constant stirring until it comes to a boil. 

If after three days in spite of this pepto- 
nizing milk powder being added, curds are 
still seen in the stool, then stop milk feeding 
and give: rice water, 4 ounces; lime-water, 
1 teaspoonful; granulated sugar, 1 teaspoon- 
ful; white of one raw egg. Feed every three 
or four hours. In preparing this formula dis- 
solve the granulated sugar in the rice water, 
and add the lime-water. At feeding time 
warm the bottle and add the white of one raw 
egg and mix by shaking the bottle. 

If persistent vomiting and green stools are 
present, then use from 4 to 6 ounces of sweet- 
ened whey. If the bowels are loose as in 

71 



72 THE HEALTH-CARE OF THE BABY 

summer complaint, and the stools are watery, 
give i teaspoonful of top milk to a teacupful 
of rice water, boil five minutes and feed when 
lukewarm. 

If diarrhea continues in spite of the above 
method of feeding, then give of rice water, 6 
ounces; lime-water, i teaspoonful; baked flour 
(see page 83), 1 teaspoonful; granulated sugar 
1 teaspoonful. Feed every 4 hours. Mix flour 
and sugar with the rice water, add lime-water, 
boil five minutes and feed when lukewarm. 



CHAPTER X 
PROPRIETARY INFANT FOODS 

THE market is filled with a large number 
of patent infant foods. This proves that 
there is a demand for something in addition 
to methods of feeding in vogue at the present 
day. Physicians as a rule condemn the use 
of these foods and chiefly for the following 
reasons : 

First. Because the laity, except in rare 
instances, are not competent to feed an in- 
fant by following directions on the label of a 
box of food. No shoe is made that will fit 
every baby's foot, and no infant food made 
will agree with and be properly assimilated 
and digested by every baby. It is a well- 
known law that individualization is more de- 
manded in infant feeding than in any other 
method of treatment. The digestive func- 
tions are totally different in various individ- 
uals, and so it must be left for the intelligent 
physician to note the size of the body to be 
fed, study the infant's wants, note the condi- 

73 



74 THE HEALTH-CARE OF THE BABY 

tion of his digestive apparatus and, last but 
not least, the stool must be properly examined. 
Then and not until then can any one prescribe 
the kind of food, the amount of food and the 
feeding interval demanded. 

Second. No greater mistake is made than 
to suppose that because an infant has gained a 
few ounces and is gaining continuously, he is 
in absolute good health. When a large amount 
of starch or transformed starch, such as dex- 
trinized starch, is fed to an infant, or when 
large quantities of sugar are given, there is 
usually a notable increase in weight. Bone 
and muscle, which are formed chiefly by the 
proteid element of food, cannot be replaced 
by the carbohydrate or fat forming substances. 
The ambition of many mothers and nurses 
is to display with pride a big fat baby and 
show large gains in weight. To accomplish 
this, frequently proprietary foods have been 
added in very large amounts, thus overtaxing 
the digestive apparatus and ending in dyspep- 
tic or enlarged stomachs. 
Advan- Having pictured the dangers it is but fair to 

pfopr?e- state that there are very many virtues in these 
Foods, proprietary foods. I advise the use of many 
of these foods in infants six months old or 
older, especially for those requiring additional 



PROPRIETARY FOODS 75 

food during the period of dentition. To the 
formula of milk and rice water previously 
given, add one teaspoonful or more of Eskay's 
food, Mellin's food or malted milk to each 
feeding. When a tendency to constipation 
exists Mellin's food or malted milk are espe- 
cially indicated. Horlick's food is a food 
which, like Nestle's food, requires no milk, 
but only the addition of water. These foods 
are nutritious when added to milk. If milk 
is overheated, as it is when subjected to steril- 
ization or prolonged pasteurization, then a 
decided constipating tendency usually re- 
sults. To prevent constipation by using these 
foods, milk or diluted milk should be simply 
warmed or used in its raw state. When milk 
is boiled, constipation, due to the altered con- 
dition of the casein (curd), results. 



CHAPTER XI 
FEEDING DURING DIARRHEAL PERIOD 

WHEN mucus continues to be present and 
the stools are thin, then milk in every 
form must be stopped. It is in this class of 
cases that even whey will not be tolerated. 
This form of diarrhea usually occurs in sum- 
mer when milk has undergone fermentative 
changes due to the presence of bacteria. As 
a temporary substitute feeding, intending to 
correct looseness, I advise the following: Nes- 
tle's food, i teaspoonful; rice water, 3 ounces. 

Rub up the Nestle's food powder with a 
little cold water, add the rice water and heat 
slowly until it comes to a boil. Do not add 
sugar or lime-water. The above quantity can 
be fed every three hours to a baby up to three 
months of age. 

For a child 3 to 6 months of age give every 
3^ hours: Nestle's food, ij teaspoonfuls ; 
rice water, 5 ounces. For an infant 6 
to 9 months of age give every 4 hours: 
Nestle's food, 2 teaspoonfuls; rice water, 7 
ounces. 

76 



DIARRHEAL PERIOD 77 

If this form of feeding is carefully prepared 
and the utensils are properly cleaned, then 
we must adhere to a proper feeding interval. 
An infant with loose bowels should be fed 
once in three hours and fed very slowly. Un- 
less we adhere to the proper feeding interval 
and give the infant an interval of rest, we can 
excite diarrhea by too frequent feeding. A 
sympathetic mother will frequently indulge 
her baby and feed too frequently, thus stimu- 
lating the bowels by too much liquid food. 
For an infant 6 months old the addition of 
1 teaspoonful of Eskay's food to 4 ounces of 
milk and 4 ounces of rice water has served 
me very well to correct a tendency to very thin 
stools. 



6 A. M. 



CHAPTER XII 

DIETARY 

FOR A CHILD FROM TWELVE TO 
EIGHTEEN MONTHS OLD 

ORANGE JUICE; apple sauce, or prune 
jelly. 
6:30 A.M. Milk, 8 ounces, with zwieback or Huntley 

& Palmer biscuit. 
10 a.m. Milk, 8 ounces. 

12:30 p. m. Four to 6 ounces of beef or chicken soup 

thickened with toast crumbs, or 2 to 3 ounces 

of expressed beef juice thickened with toast 

crumbs. 
2:30 P.M. Milk, 8 ounces, with Huntley & Palmer 

biscuit. 
5 p. m. A saucer of apple sauce or prune pulp. 

6:30 p. m. Milk, 8 ounces. 

FOR A CHILD FROM EIGHTEEN MONTHS 
TO THREE YEARS OLD 

6:30 A.M. Orange juice; apple sauce, or prune jelly. 

7 a.m. Milk, 8 ounces, with Mellin's food, 1 tea- 

spoonful, or Eskay's food, 1 teaspoonful; 
zwieback or Huntley & Palmer biscuit. 

78 



DIETARY 79 

A saucer of: Farina; hominy; cream of ha. m 
wheat; oatmeal, or arrowroot, and warm milk 
6 ounces. 

A soup, a meat, a vegetable, and a cracker. 2 p. m. 

Beef or chicken soup thickened with split 
peas, sago, rice or farina; clear broth with 
yolk of egg or one or more ounces of expressed 
beef juice. 

Joint of chicken; fish (broiled halibut); 
raw scraped steak; chicken or calfs-foot jelly 
without wine flavor. 

Baked potato; spinach; carrots; cauli- 
flower; asparagus; or stewed celery. 

Huntley & Palmer biscuit; graham wafer; 
Albert cracker; or lady finger (stale). 

Water. 

A cup of milk or cocoa, a pudding and a 6 p. m. 
cracker. 

Warm milk, 5 ounces, with white of egg; 
cocoa, 5 ounces. 

Junket; custard; cornstarch pudding; tap- 
ioca pudding; farina pudding; or soft boiled 

egg- 

FOOD RECIPES 

To make barley water add one tablespoon- Barley 

J r Water. 

ful of pearl barley to one quart of cold water, 
boil two hours, adding water from time to time. 
Strain through muslin and add enough boiled 



80 THE HEALTH-CARE OF THE BABY 

water to make one quart. When the barley 
flour is used mix two teaspoonfuls of the flour 
in a little cold water, add one quart of water 
and boil fifteen minutes. Strain through 
muslin if there are any lumps, and add enough 
boiled water to make one quart. 

•^ er Rice water is made in the same manner as 

barley water, one tablespoonful of rice being 
used to one quart of water. When rice flour 
is used, add two teaspoonfuls to a quart of 
water. 

oatmeal Oatmeal water is made in the same manner 

Water. 

as barley water. Use one and one-half table- 
spoonfuls of oatmeal to one quart of water. 

Gruels. Gruel is made by adding two teaspoonfuls 

of rice flour, barley flour or oatmeal to one 
pint of cold water, and boiling briskly for 
one-half hour. Add a pinch of salt and a 
teaspoonful of granulated sugar. 

Albumin To make albumin water add the white of 

Water. , ,. . , _ 

one raw egg to one-half pint of water. Pour 
the egg and water into a clean bottle and shake 
well, Feed through a nipple or by spoon. 
Nutritious A nourishing drink is made by adding the 
ade. juice of half a lemon to the yolk of a raw egg; 

let it stand for five minutes, and then add two 
teaspoonfuls of granulated sugar and five 
ounces of water. 



DIETARY 8 I 

Beat the white of one raw egg with one Nutritious 
teaspoonful of granulated sugar and add the 
juice of one orange and five ounces of water. 

Take one-half pint of fresh cows' milk and Junket. 
heat it lukewarm (about ii5°F); add one 
teaspoonful of Fairchild's essence of pepsin 
and stir just enough to mix. Pour it into 
cups and let it stand in a cool place until 
firmly curdled. Serve plain or with a little 
sugar. 

Curdle warm milk with the essence of pep- whey. 
sin as directed in making junket. After the 
milk has curdled or clotted beat up the curd 
with a fork and strain it. The liquid is the 
whey which may be sweetened by adding one 
teaspoonful of granulated sugar. 

Expressed beef juice is obtained by slightly Beef 
broiling a piece of lean beef, and squeezing 
the juice from it with a lemon squeezer or a 
meat press. One pound of steak yields from 
two to four ounces of juice. Flavor it with 
a little salt and slightly warm it by standing 
a cup containing the beef juice in a bowl of hot 
water. 

Take one pound of lean mutton, veal, beef Broths. 
or chicken, including some of the bone, a 
sprig of parsley and a blade of celery for one 
quart of cold water containing a pinch of 



82 THE HEALTH-CARE OF THE BABY 

salt. Cook slowly for three hours, strain 
through muslin and remove the greater part 
of the fat. 
very Weak, cold tea (English Breakfast) made 

Thfrst r ky steeping about three tea leaves in one cup 
of boiling water for two minutes, is very valu- 
able to quench thirst in a baby suffering with 
diarrhea. Two or three teaspoonfuls may 
be given at one time and repeated every half- 
hour. Besides the cooling effect tea has a 
decided astringent property which makes it 
valuable in diarrhea, 
Gelatin A delicious dessert for a child two years old 

Pudding. J 

or older is made with gelatin powder and 
hot water. Cox's, Knox's, or Price's gelatin 
powder may be used. The directions for the 
proper proportion of powder and water will be 
found on each label. 

custard. Beat together one fresh egg and a teaspoonful 
of granulated sugar; pour into a cup and add 
four ounces of milk, then tie over the cup a 
piece of linen, place the cup in a shallow sauce- 
pan half full of water, and boil ten minutes. 

soft-boiled Place a fresh egg in enough boiling water 
to cover it, move it to the back of the stove 
and let it stand five minutes where the water 
will keep hot, but not boil. Serve with a 
pinch of salt. An egg to be properly cooked 



DIETARY 83 

should never be boiled in boiling water, as 
the white hardens before the yolk is cooked. 
The yolk and white should be of a jelly-like 
consistency. 

Place a slice of bread in the oven, and dry Toast, 
until crisp but not brown. Place it on a toast 
fork and hold it over the flame of a coal fire 
for a few seconds until brown on both sides. 
Butter while hot. 

This meat pulp is prepared by scraping Raw 
with a dull knife a piece of raw or underdone steak. 
round steak. Add salt to taste. The raw 
yolk of egg may also be added to the meat. 

Tie several pounds of wheat flour in a Baked 

r Flour 

cheese-cloth bag and boil in a pot of water for g^g* 
five hours. Remove from water and place 
in oven, and bake until quite brown on the 
outside. It will require from two to three 
hours slow baking. Break open and throw 
away the brown shell; the remainder, the 
baked flour, must then be grated into a 
powder. 



PART III 

Miscellaneous Diseases and Emergencies 



T 



CHAPTER I 
VOMITING AND COLIC 

HERE are so many causes for vomiting From 
in infants and children that whatever it F m e P dmg. r 



be, the cause should be carefully studied. 
Vomiting may be the result of over feeding, or 
due to infants gulping their food or drinking 
it too hastily. When the vomiting that is due 
to improper feeding continues, absolute rest 
of the stomach is demanded. In such cases 
from an interval of two hours there should be 
a change so that we feed once in three or even 
four hours. In many cases of vomiting the 
food is too rich in fat (cream); hence more 
water should be added. When vomiting fol- 
lows breast feeding, the baby should receive 
several teaspoonfuls of rice or barley water 
before each breast feeding to dilute the breast 
milk. 

Vomiting may be caused by disease; hence 
repeated vomiting with or without fever means 
something more than a trivial stomach com- 
plaint. For example: If a child falls down 

87 



88 THE HEALTH-CARE OF THE BABY 

a flight of stairs and continues to vomit, such 
vomiting is due to concussion of the brain. 
If a child is developing scarlet fever the first 
symptom usually noted will be repeated at- 
tacks of vomiting. Brain fever (meningitis) 
frequently begins with vomiting. No amount 
of changing of the food formula will relieve 
such attacks. 

When vomiting occurs, give a dose of castor- 
oil, or a rhubarb and soda tablet, dissolved in 
a little water, repeat this dose in two hours if 
vomiting continues. Dilute the food by using 
one-half the quantity of milk previously given 
and add an equal part of water. If vomiting 
still persists after these measures have been 
taken, consult the physician at once, 
colic Colic, as it frequently occurs in young in- 

fants, is usually caused by indigestion. It 
occurs most frequently in bottle-fed infants. 
When it occurs frequently in a breast-fed in- 
fant, give an ounce of hot water just before 
nursing. The mother should see that her 
bowels move freely each day; she should take 
plenty of exercise and a light, nourishing diet. 

When colic exists baby will draw up his 
legs on the abdomen and cry and scream. I 
have already in the article on "Cry," called 
attention to the peculiar, sharp cry denoting 



CONVULSIONS 89 

pain. The abdomen is usually distended 
and if the ear is placed over the abdomen a 
distinct rumbling noise can be heard. No 
amount of rocking or soothing will comfort 
the baby until the colic is relieved. A hot- 
water bag, or a warm flaxseed poultice, should 
be applied to the abdomen. Rubbing the 
abdomen with warm sweet-oil, as described 
in the article on massage, will usually relieve 
the pain. One drop of essence of peppermint 
to a teaspoonful of warm water may be given 
every fifteen minutes until baby is soothed. 
Injections of warm soap water into the bowel 
will instantly relieve the colic. When colic 
recurs the food requires modification. As a 
rule we must add less milk and increase the 
diluent, be it rice or barley water. 

Hiccup is due to a spasm of the dia- Hiccup. 
phragm. A tight-fitting abdominal bandage 
will frequently check this spasm. One drop 
of Hoffman's anodyne may be given every 
hour to a baby one year old, and every half- 
hour to an older child. 

If the baby overloads his stomach, or ifconvui- 
improper food has been given and stagnates 
in the intestine, general poisoning may result, 
with fever and convulsions. When convul- 
sions appear the muscles of the arms and 



sions. 



90 THE HEALTH-CARE OF THE BABY 

legs are usually stiffened, the facial muscles 
are distorted, the eyes roll upwards, the jaws 
are firm, the teeth locked, and frothing of the 
mouth may take place. When convulsions 
occur the physician should be summoned; 
until then, the following general rules should 
be followed: 
Mustard An ice-cold cloth or an ice-bag may be laid 

Foot-bath. ° , 

on the head. A mustard foot-bath should be 
given by immersing the feet in water, as hot 
as can be borne by the hand, to which one 
or two tablespoonfuls of powdered mustard 
should be added. The feet should be bathed 
until the skin is reddened or until the muscu- 
lar rigidity ceases. The bath should not be 
prolonged more than three minutes. If the 
spasm continues after the mustard foot-bath 
has been given, then a pint of soapwater 
should be injected into the bowels as an enema 
and continued until a movement of the bowels 
results. 



CHAPTER II 
CONSTIPATION 

THE baby's bowels should move at least 
once in every twenty-four hours. If the 
action of the bowels is sluggish, he will not 
have a movement every day. This sluggish 
action can be caused by different conditions, 
but is most often due to faulty feeding. If in Breast 

fed. 

the baby is fed at the breast, the mother or wet- Babies 
nurse must see that her breast milk is kept in 
a healthy state. Her milk should be exam- 
ined by a physician or chemist to determine 
whether or no enough fat (cream) is present. 
If a deficiency of cream exists then we can give 
baby one or more teaspoonfuls of cream from 
cows' milk, in a little warm water immedi- 
ately before nursing. Several teaspoonfuls of 
water sweetened with granulated sugar and 
given before nursing will frequently relieve 
constipation. 

If the baby is bottle-fed and his digestion in Bottie- 
is good, then increase the quantity of cream Babies - 
or top milk by adding a teaspoonful or more 

9 1 



92 THE HEALTH-CARE OF THE BABY 

to each bottle. If milk has been subjected to 
prolonged heating, then stop using boiled or 
sterilized milk and give raw milk which is 
warmed to about ioo° F. or the usual feeding 
temperature. A teaspoonful or more of Mel- 
lin's food added to each bottle will modify 
constipation for the time being. A teaspoon- 
ful or more of malted milk added to each 
bottle will also have a laxative effect. 

When constipation follows the use of Es- 
kay's food, it can be corrected by adding 5 
to 10 grains of phosphate of soda or calcined 
magnesia to the morning bottle. No more 
than one dose should be given in a day. If 
this does not correct the constipation, then no 
change of food should be made without medi- 
cal advice. 

water. A drink of water between feedings will fre- 

quently help to relieve continued constipation. 

Fruits and The scraped pulp of a raw apple or the pulp 

jukes. f a good mellow peach will aid in relieving 
constipation. Apple sauce or prune jelly may 
be given between meals. Orange juice, grape 
juice, pineapple juice or apple cider will be 
found beneficial. 

Massage. Kneading or stroking the abdomen over 
the bowels will stimulate the circulation if 
regularly performed. The fingers or hands 



CONSTIPATION 93 

of the mother or nurse should be oiled and by 
means of gentle stroking begin in the following 
manner: Have your hands warmed as well 
as oiled, begin at the right groin and lightly 
rub the fingers in a circular motion upward, 
until the umbilicus is reached; then rub 
across the umbilicus and down the left side 
to the groin. Begin again at the right groin 
and press a little deeper each time as the 
baby grows used to it. This should be done 
every morning and evening for from five to 
ten minutes and can be continued for several 
weeks. In obstinate cases several months of 
treatment may be necessary. 

The baby, as I have said, should not be Enema, 
allowed to go more than twenty-four hours 
without a movement. Immediate relief can 
be given by an injection into the bowel through 
the rectum of one-half pint of luke warm 
castile soap water, to which one tablespoon- 
ful of glycerin has been added. 

Sometimes a very little stimulant to thesupposi. 

tories. 

rectum is all that is needed. A suppository 
usually acts quickly. The best for the baby 
are those made of glycerin or gluten. They 
are small and conical in shape and resemble 
the old-fashioned "soap stick." One of these 
suppositories should be dipped into vaselin 



94 THE HEALTH-CARE OF THE BABY 

or olive-oil and gently inserted into the baby's 
rectum and held there until the movement 
pushes it out. These suppositories may be 
continued for several weeks. 
Drugs. No mother or nurse should give the baby 

any drugs for his bowel movements without 
the supervision of a physician. They should 
try any or all the remedies here suggested be- 
fore giving the baby any drugs. Many cases 
of death by poisoning have occurred through 
the careless use of patent cathartics. 



CHAPTER III 
MALNUTRITION (MARASMUS), RICKETS, ETC. 

WHEN the baby, who has been in good 
health while fed with human breast 
milk, is suddenly deprived of this good food, 
trouble usually begins. If too rich cows' 
milk, such as top milk or cream is tried, the 
baby will vomit and be colicky, the stool will 
contain curds and as a result there will be 
restlessness and crying day and night. The 
colic and the vomit denote that the food does 
not agree with the stomach. Such infants 
require an immediate change of food suited 
to their digestion. If this trouble is not 
rapidly corrected, they do not gain in weight 
but lose. When this condition persists for 
a month or two, the fatty cushions on the arms 
and legs disappear and the infant seems to 
shrivel up, pine and waste away. These in- 
fants resemble little skeletons and their skin 
hangs in loose folds. Such infants require 
fresh air and frequently owe their marasmus 
to being deprived of it in tenement-houses or 
small, ill- ventilated apartments. 

95 



96 THE HEALTH-CARE OF THE BABY 

The milk of a wet-nurse, even though her 
milk is several months younger than the 
marasmic baby, will frequently work wonders ; 
goat's milk, properly modified, is frequently 
adapted to relieve this condition. The diffi- 
culty in prescribing proper food for a maras- 
mic child should be thoughtfully considered 
by the mother or nurse before resorting to 
experimental feeding. The physician should 
be called and a definite plan of treatment fol- 
lowed. We must not expect to see immedi- 
ate changes, although improvement should be 
noted within four weeks. As the life of the 
child is at stake, no conscientious mother or 
nurse will risk experimenting with the food, as 
such attempt may prove fatal. Cod-liver oil 
and malt may do good, but even these remedies 
should not be given without medical opinion. 
Rickets. Rickets is a disease caused by improper 
feeding and improper ventilation. The bones, 
instead of being hard and firm, are soft and 
spongy, and sometimes very thin. The mus- 
cles, instead of being hard and firm, are soft 
and flabby. There is a general backwardness 
of development. Rickety children are back- 
ward in teething, and when the teeth do ap- 
pear, decay very rapidly. They are back- 
ward in walking and backward in talking 



RICKETS 97 

and the soft-spot (fontanel) on the top of the 
head remains open months longer than it 
should. Owing to the soft bones which yield 
on walking the child becomes bow-legged. 
The ends of the bones are enlarged, and the 
ribs are beaded. 

These children usually suffer from con- 
stipation and have a distended abdomen. 
They are restless at night and peevish by day. 
They perspire freely, especially while feed- 
ing. The back of the head is usually bald 
from rubbing the head back and forth on the 
pillow. If a breast-fed baby shows signs of 
rickets the breast milk must be examined at 
once by a chemist in order to determine the 
quantity of fat, sugar and proteids that it 
contains. When nursing is prolonged and 
the mother menstruates regularly, rickets may 
develop. As a rule babies fed on condensed 
milk or those receiving insufficient fat or 
cream develop rickets. When the baby is 
kept indoors and over-bundled with clothing, 
he soon loses his appetite and if this con- 
tinues for weeks and months he will become 
under-nourished, and as a result rickets in some 
form will be shown. Fresh cows' milk simply 
warmed, not boiled, should be given. Fruit 
juices, such as orange, lemon, pineapple and 



98 THE HEALTH-CARE OF THE BABY 

grape juice and raw- scraped apple pulp should 
be given. Butter, yolk of raw egg, with 
sugar, cereals, and the dairy products, such 
as cream cheese should form the bulk of the 
diet. When severe constipation is encoun- 
tered, honey and several teaspoonfuls of sweet 
oil may be given daily. Cod-liver oil, maltin 
or morrholin should be given in doses of one 
teaspoonful three times a day. Rickety chil- 
dren require fresh air; they should sleep in 
well-ventilated rooms. While out of doors, 
they should be placed in the sun. A sun bath 
is very important. The daily morning bath 
should be of lukewarm water to which one 
pound of sea salt is added. After the bath 
the child should be briskly rubbed with a 
coarse turkish towel. No case of rickets 
should be neglected, or the deformities will 
remain throughout life, 
scurvy. A child that has been improperly fed will 

frequently show evidences of such bad feed- 
ing by having a weakened framework. The 
bones will be spongy and the muscles flabby. 
The joints will swell and resemble rheuma- 
tism. The child will be covered with bluish- 
black spots as though it were bruised. New 
spots will appear when the child is roughly 
handled. The gums, with a deep purple 



JAUNDICE 99 

color, are swollen and look spongy. They 
frequently bleed. Nosebleed or blood in the 
urine and stools accompanies this condition. 
The child appears pale and has no appetite. 

If the child has been fed with a patent food 
its food must be changed at once. Raw milk 
must be given and all forms of steaming and 
sterilizing must be stopped. Orange juice, 
grape juice and raw steak juice must be added 
to the diet. This is generally all the treatment 
necessary. 

In jaundice there is an intense yellowish jaundice, 
color to the skin. The whites of the eyes ap- 
pear yellowish. The urine instead of being 
yellow in color has a brownish color. The 
stools instead of being brown, are white or 
clay colored. The child may vomit and fever 
may be present. Headache will be com- 
plained of by older children. They are lan- 
guid and tired and will want to go to bed. 
When the new-born baby has jaundice the 
physician should at once be summoned. 
Jaundice may be caused by a liver distur- 
bance or by some poison in the blood. In 
older children jaundice is frequently asso- 
ciated with catarrh of the stomach, in which 
case it extends to the bile ducts. Under the 
care of a physician these cases recover. 

COFC. 



CHAPTER IV 
FEVER AND TEMPERATURE 

THE normal temperature of a baby ranges 
between 98 1 and 99 J° F. If the baby 
has a temperature of 99 to ioo° F he should 
not be considered feverish. A temperature 
of 101 to 102 F usually means a mild disease. 
A temperature of 103, 104 or 105 F means a 
severe febrile condition. Children are very 
sensitive and hence respond very quickly to 
conditions giving rise to fever. For instance, 
an overloaded stomach or a stagnant bit of fer- 
menting milk-curd in the intestine will give 
rise to auto-intoxication resulting in fever as 
high as 105 F and frequently will cause con- 
vulsions. 
sudden If a child is well in the morning and sud- 

denly develops a temperature of 103, 104 or 
105 F, this usually implies a sudden dis- 
turbance of the stomach or bowels. As a rule 
sudden fever is not dangerous, but responds 

readily to treatment. 

100 



FEVER AND TEMPERATURE IOI 

When fever comes on gradually, and in- Fever De- 
creases J to i degree every day for a number siowiy. 
of days, it is usually a bad sign. This form 
of temperature is met with in typhoid fever. 

It is important to remember that fever is when 

Fever is 

absent in many diseased conditions. For ex- Absent. 
ample, brain fever and even scarlet fever and 
pneumonia may sometimes be present and 
still the temperature of the body be normal 
during the whole course of the disease. 

A teaspoonful of castor-oil is always a safe what to 

^ i ; r dofor 

remedy no matter what brought on the fever. Fever. 
A teaspoonful of aromatic sirup of rhubarb 
may be given once only. One of the most 
rapid methods of reducing fever is by wash- 
ing out the bowel, with a pint of soap water, 
by means of a fountain or bag syringe. If the 
mother or nurse is skillful the injection may 
be given high up in the bowel, by introducing 
a catheter two or three inches into the rectum 
and following it up into the colon three inches 
more. Fifteen drops of sweet spirits of niter 
in a teaspoonful of water may be given. This 
may be repeated every hour until three or 
four doses have been given. As niter acts on 
the kidneys it eliminates fever and poisonous 
products through the kidneys by increasing 
the flow of urine. 



102 THE HEALTH-CARE OF THE BABY 



Sponging 
the Body. 



Rash. 



Feeding 

During 

Fever. 



If fever persists then a sponge bath, con- 
sisting of one part of alcohol and five parts 
of cold water, should be given. The body- 
should be sponged every half-hour until the 
physician arrives. 

If an eruption is found on the body, a phy- 
sician should be consulted before any spong- 
ing or cooling is begun. 

If the child is still on a milk diet, we should 
give a weaker food by taking away half the 
quantity of milk and adding the same amount 
of water. In some fevers even weak milk will 
not be tolerated and nothing but whey or thin 
soups will be tolerated. 

Older children who have been on a diet of 
solid food should receive only liquids during 
the fever. Plenty of water should be given. 



CHAPTER V 

GENERAL RULES FOR CONTAGIOUS DISEASES 
AND FEVERS 

PUT the child to bed. 
Give a teaspoonful of castor-oil or aro- 
matic sirup of rhubarb. 

One hour later give an infant 15 drops of 
sweet spirits of niter, and an older child 30 
drops. 

If twitching of the muscles is noticed and 
the child has had convulsions before, then 
give a strong mustard foot-bath for two or 
three minutes. 

If twitching continues one-half hour after 
the foot-bath, then give an injection into the 
rectum of one pint of soap water. 

For thirst give one or several tablespoon- 
fuls of citrate of magnesia. 

Do not give pure milk in fever but dilute 
the food one-half. Thin soups, lemonade 
and orangeade may also be given. 

Do not bathe the child if an eruption is 
seen on the skin unless the physician especi- 
ally orders it. 

103 



104 THE HEALTH-CARE OF THE BABY 

Wrap the patient in a blanket and take 
him out of the sick-room into an adjoining 
room twice a day to permit thorough ventila- 
tion of the sick-room. 

All bed linen and clothing of a child worn 
during a contagious disease should be soaked 
over night in a solution of 1-2000 bichloride 
or in javelle water before being boiled and 
washed. All visitors and friends should be 
excluded from the sick-room until the phy- 
sician has made the diagnosis. 



CHAPTER VI 

MEASLES, SCARLET FEVER, DIPHTHERIA AND 

CROUP 

IN measles the first thing usually noticed by 
the mother is that the baby appears to 
have taken cold. He will sneeze, have a 
catarrh in the head and cough. The eyes 
are dull, the appetite poor and there is usually 
fever. Three or four days later a rose-colored 
rash will appear on the face and neck, and 
later spread to the chest, arms and legs. 

At the first symptoms the baby should be 
put to bed in a darkened room, or with his 
back to the light on account of the inflamma- 
tion of the eyes. Plenty of fresh air should 
be allowed to enter, and the temperature of 
the room kept at about 70° F. All other 
children should be kept from the room or 
house if possible, as nine out of every ten, if 
exposed, will take this disease. If children 
remain well fourteen days after exposure, then 
they will probably escape. As a rule the dis- 
ease appears between seven and fourteen days 

105 



Io6 THE HEALTH-CARE OF THE BABY 

after an exposure. Bathing should be stopped. 
No child should be permitted out of bed, no 
matter how good he feels until the rash has 
entirely disappeared. This may in some cases 
require a child to be in bed one or two weeks. 
Complications can be avoided by this pre- 
caution. It is the careless mother or nurse 
who, disregarding a mild bronchitis, will ex- 
pose a sick child in order to harden it and 
later be rewarded by finding that the child 
has contracted a fatal pneumonia. Con- 
tinued fever after the measles' rash has dis- 
appeared means the development of some 
complication. 
German This disease resembles ordinary measles, 

Measles. ' 

although it is a much milder disease and does 
not begin with sneezing and coughing. Some- 
times there is a slight fever, but more often 
the first symptom noticed is the rash. The 
pale red rash usually appears all over the 
body. It varies in size from a pin-head to a 
small pea. It disappears in three or four 
days. The child should be kept in bed and 
put on a light diet. This is all the treatment 
necessary. The patient should be isolated. 
If a child has been exposed to this disease he 
will usually show signs of it at any time from 
the fourth to the twentieth day after exposure. 



MEASLES, SCARLET FEVER, ETC. 107 

The early symptoms of scarlet fever arescariet 
sore throat, headache, high fever, and vomit- 
ing which may occur in spite of a most careful 
diet. Convulsions sometimes occur. From 
twenty-four to thirty-six hours after the first 
symptoms are noticed a rash of a deep red or 
bluish- red color usually appears, first on the 
neck and chest, and later covering the body. 
This rash is very fine and the parts of it ap- 
pear so close that the whole body has a very 
red appearance. This rash usually remains 
five or six days and then begins to peel off or 
desquamate; this usually takes from two to 
four weeks. The strictest isolation must be 
observed. The desquamated skin can trans- 
mit the disease to a healthy child, months after 
the patient has recovered. 

A child after being exposed to a case of 
scarlet fever may show the first symptoms 
any time within twelve days. All bedding 
and clothing coming in contact with the 
patient must be thoroughly disinfected by 
being soaked in a solution of 1-2000 bichloride 
solution over night before being boiled and 
washed. The toys should be burned. The 
treatment must be left to the physician* 

Chicken-pox is a contagious disease. If the chkken- 
baby has been exposed he will probably have 



io8 THE HEALTH-CARE OF THE BABY 

an eruption between the fourth and fourteenth 
days after exposure. Usually the first symp- 
tom noticed is a slight fever and a series of 
pimples scattered over the body. These pim- 
ples are at first small, and gradually grow 
larger and resemble water blisters. In a few 
days they dry up and the crust falls off. The 
eruption does not all appear at one time, for 
while new pimples are forming, others are 
drying up. This disease is frequently found 
in very young infants, especially if they have 
not been vaccinated. There is no danger in 
this disease if the child is kept in bed, the 
bowels cleansed, and no solid food is given. 
It may be communicated to healthy children 
as late as sixteen days after the first symp- 
toms appear. 
Diph- Usually the first symptoms of diptheria are 

loss of appetite, swelling of the glands at the 
angle of the jaw and grayish white or yellow- 
ish patches in the throat. As soon as the 
mother sees patches in her baby's throat she 
should notify her physician at once. If they 
are true diphtheritic patches prompt treat- 
ment must be given if the baby's life is to be 
saved. Until the physician arrives, one or 
two glasses of citrate of magnesia may be 
given to cleanse the bowels. No solid food 



DIPHTHERIA AND CROUP 109 

should be given, only milk, gruels and broths. 
For thirst, ice-cream and water ices should be 
taken. For very young infants dilute the 
food one-half with water. The patient must 
be strictly isolated. If other children are ex- 
posed, they are likely to get the disease any 
time within four weeks after exposure. 

There are two kinds of croup, catarrhal or False 
false croup and diphtheritic or true croup. 
Catarrhal or false croup is the kind that comes 
on suddenly in the night in an apparently 
healthy child. It is the result of a simple 
filling up with mucus. The baby may have 
had a cold or been exposed, but more often 
no special cause can be found for this sudden 
attack. The baby may wake up during the 
night with a hoarse barking or crowing cough, 
and seem to breathe with difficulty. 

One of the best methods of relieving this 
cough is to have a croup kettle or a teakettle 
with a long spout so placed that steam coming 
from the kettle will be inhaled by the baby. 
Ten or fifteen drops of spirits of turpentine 
may be added to the steaming water. This 
steam should be kept up for several hours so 
that the air in the room becomes saturated. 
If the attack is very severe a teaspoonful of 
sirup of ipecac may be given. If vomiting 



IIO THE HEALTH-CARE OF THE BABY 

does not result then give another dose of 
ipecac in twenty minutes. This form of croup 
comes on suddenly and disappears suddenly 
if the emetic is given. There is no danger 
to a child's life even though such an attack 
comes on after exposure to cold. 
Tme A croupous cough that is accompanied by 

fever and comes on very slowly is usually of 
a serious nature. If white patches or spots 
can be seen in the throat then the sooner the 
physician is consulted the better for the child. 



T 



CHAPTER VII 

WHOOPING-COUGH AND TONSILLITIS 

HE first symptoms of whooping-cough whooping- 
are those of an ordinary cold with a 



cough. This lasts about ten days, when the 
cough gets stronger until a pronounced spasm 
appears. These spasms consist of a number 
of short, quick coughs, then a long-drawn 
inspiration known as "the whoop." During 
these coughing spasms the baby will get very 
red, sometimes bluish-red in the face, and 
frequently the spasm ends with a vomit. It 
will be noticed that the cough is worse indoors 
and is least troublesome out-of-doors. The 
spasms are strongest at night. This is usually 
so because the windows are tightly shut. 
Fresh air night and day are very necessary for 
a cure. 

The danger in whooping-cough consists of 
exhaustion following lack of food as a result 
of the constant vomiting. If a breast-fed 
baby suffers with whooping-cough, the feed- 
ing should be more frequent and less in quan- 
tity. The same rule applies to a bottle-fed 



in 



112 THE HEALTH-CARE OF THE BABY 

baby. For example: If baby has been re- 
ceiving a bottle containing six ounces every 
three hours, he should, while the vomiting 
lasts, receive a bottle containing four ounces 
every two hours. If the swallowing of food 
provokes a coughing spasm and results in 
vomiting, then the food may be given, in some 
cases every hour. In this method baby will 
have a chance to obtain a little nourishment 
from his food before it is thrown off. Con- 
centrated food, such as yolk of egg, white of 
egg, and steak juice, made by expressing the 
juice from broiled steak, may be given. Older 
children may receive custard, junket, cereal 
puddings and raw-scraped steak mixed with 
the yolk of an egg. Cod-liver oil in teaspoon- 
ful doses given three or four times a day will 
nourish the body. Medication does not, as 
a rule, help in this disease. Whooping-cough 
runs its course in about twelve weeks; plenty 
of fresh air night and day, or a change of air 
to the seashore or mountains, tends to shorten 
the disease. Whooping-cough is one of the 
most contagious diseases and if a well child is 
exposed to it he is pretty sure to show symp- 
toms within three weeks after exposure. 
Cold in One of the most common disorders of child- 

the Head. 

hood is cold in the head. Sneezing, sniffling, 



TONSILLITIS AND ADENOIDS 113 

and a running nose are the symptoms. If 
fever accompanies the cold, consult a physi- 
cian, as a running nose is frequently a symp- 
tom of adenoids and one of the earliest symp- 
toms of measles. Relief can be afforded by 
syringing the nose with warm water contain- 
ing a pinch of bicarbonate of soda, morning 
and evening. If the nostrils are plugged with 
mucus one or two drops of alboline or sweet 
oil should be dropped into the nostrils from 
a spoon or a medicine dropper. Older chil- 
dren can be allowed to sniff salt water into 
the nostrils. 

When a child refuses to eat and has fever Tonsillitis, 
the throat should be examined. If the tonsils 
are inflamed they will be either reddened or 
coated with whitish pin-point spots. The 
temperature may reach as high as 102-104 F. 
Until a physician can prescribe, citrate of 
magnesia may be given in wineglassful doses, 
as it will relieve the thirst and has a laxative 
effect. Cold cloths should be wrapped around 
the neck and small pieces of cracked ice or ice- 
cream may be given by the mouth. 

This disease should be treated by a physi- 
cian to avoid having chronic enlarged tonsils 
which may require removal later on. 

Adenoids consist of small masses of red- Adenoids. 



114 THE HEALTH-CARE OF THE BABY 

dened granulations resembling proud flesh. 
They occur in the back of the nose and on the 
pharynx. They can seldom be seen by look- 
ing into the throat, but can be felt by intro- 
ducing the finger into the throat. If the child 
snores at night, is restless and cannot sleep, 
if it cannot breathe through its nose and the 
mouth is used for breathing, then adenoids 
are very likely present. When catarrh recurs 
several times adenoids usually develop. Bed- 
wetting is frequently noted in children suffer- 
ing with adenoids. These children are peev- 
ish, sensitive and cry; they are very nervous 
and must be coaxed to eat. They gag and 
vomit easily. They are usually very thin and 
frail and backward in development. They 
have a foul breath. If adenoids are present 
they should be removed by the physician. 
Mumps. In mumps the glands situated under the 
angle of the jaw at the sides of the neck be- 
come swollen. Sometimes both sides are af- 
fected. There is a loss of appetite, pain on 
opening the mouth and sometimes a slight 
fever. This disease can spread; hence all 
children must be kept away from it. If a 
child has been exposed he may develop symp- 
toms as late as two or three weeks. These 
cases get well very easily if a liquid diet is 



SWOLLEN GLANDS 115 

given, the bowels kept loose, and the swollen 
parts protected with absorbent cotton and 
oil silk. 

Swollen glands may occur on the sides of swollen 
the neck or below the jaw, under the arms or 
in the groins. These swellings may disap- 
pear of themselves, but when they remain for 
months we must suspect a constitutional dis- 
ease, such as tuberculosis or scrofula to be 
the origin of the trouble. When glands swell 
on either side of the neck, the throat, espe- 
cially the tonsils, require examination. Swollen 
glands in the neck may be caused by diph- 
theria in the nostrils or throat, or by an abscess 
forming in the middle ear. Lice will some- 
times cause swelling of the glands around the 
neck and back of the head. Swollen glands 
will sometimes appear in the armpits after 
vaccination. A proper examination should be 
made by the physician to determine the cause 
of the glandular swellings. 



CHAPTER VIII 
SKIN DISEASE 

Eczema. TJ 1 CZEMA usually occurs as an inflamma- 
-" tory redness of the cheeks, arms and 
legs, especially between the thighs. It may 
occur at any age and is most frequently met 
with in the bottle-fed infant suffering with 
constipation and especially in babies suffer- 
ing with rickets. It may also be the result of 
unsanitary measures such as permitting an 
infant to fall asleep and not change its soiled 
diaper. Fever does not accompany this con- 
dition. 

When eczema exists no soap should be used. 
The skin should be bathed in warm milk to 
which equal parts of bran water has been 
added. Bran water is made by adding one 
cupful of bran to one quart of hot water, al- 
lowed to soak for one-half hour, and then 
stirred occasionally and the liquid poured off. 
Oatmeal water may also be used to bathe the 
parts and will relieve the itching. After the 

116 



SKIN DISEASE 117 

bath apply zinc salve. If the eczema does 
not disappear within a few days after the above 
treatment a physician should be consulted. 

In summer during extreme heat a finely Prickly 
mottled rash is sometimes found on the skin 
of children. This condition may also occur 
in winter if the child is too warmly dressed 
To relieve this, the flannels must be laid aside 
and only muslin or linen worn next to the 
skin. The body should be powdered with 
talcum or wheat flour after being washed with 
pure cold water. If itching accompanies this 
rash, a bran bath should be given. 

Very tight underclothing or very warm chafing, 
clothing produce perspiration. If such per- 
spiration is very acid, it may cause irritation 
and by the friction of the clothing develop 
inflammation. When this continues the skin 
will appear highly inflamed and reddened, 
and at times develop crusts resembling eczema. 
When the buttocks or the genital tract is in- 
flamed and reddened we will notice that the 
child moves its legs or an attempt to scratch 
is made by rubbing the thighs. If this con- 
dition persists for a number of days then the 
skin between the thighs will develop crusts 
and we have an eczema. Neglect to change 
a wet diaper may cause chafing. If a baby 



Il8 THE HEALTH-CARE OF THE BABY 

is soiled from stool and not properly cleaned, 
chafing may occur. 

Do not use water to bathe the child. Clean 
the chafed parts with sweet oil and dust liber- 
ally with corn-starch. Zinc salve should cover 
the inflamed parts and if they do not im- 
prove within twenty-four hours consult a 
physician. 

chapped A tender skin when exposed to severe wind 

and Face, will sometimes crack and the skin appear 
very rough. This condition is very likely to 
occur if the skin is not properly dried before 
going out in the cold weather. At times a 
slight oozing of blood may take place. Apply 
melted cocoa-butter, cold-cream or zinc salve 
three or four times a day and stop bathing 
with water for at least one week. 

sunburn. A highly inflamed and reddened skin fre- 
quently results from exposure to the sun's 
rays. Camphor ice, zinc salve or sweet cream 
from top milk applied several times a day will 
remove this inflammation. 

Hives. Round red blotches, sometimes as large as 

a twenty-five cent piece, having a whitish 
center resembling a mosquito bite, may ap- 
pear on the skin. They frequently follow a 
disordered stomach. These blotches come 
and go very quickly and require cooling with 



SKIN DISEASE 119 

baking-soda moistened with cold water and 
made into a paste. As a rule a dose of castor- 
oil or a teaspoonful of rhubarb and soda 
mixture for a baby one year old may be re- 
peated once every three hours until the bowels 
are thoroughly cleansed. For a baby six 
months old one-half the dose should be given. 
It is a good plan to stop all milk for at least 
six to eight hours, and give instead sweetened 
rice-water or plain water. In an older child 
stop eggs or meat one or two days and give 
buttermilk instead. Plenty of water should 
be permitted. 

Boils are abscesses of the skin and usually Boils, 
occur on the head and neck. They are most 
frequently due to local infections. When 
these boils occur on the scalp the hair should 
be trimmed around the boil and an incision 
will be necessary to empty the pus. All boils 
require careful antiseptic dressings which 
should be applied by a trained nurse or a 
physician. 

To remove the heat from a sting of an in- Mosquito 
sect or mosquito, the parts should be bathed 
with spirits of camphor or pure alcohol. If 
a child is forced to live in a locality where 
mosquitos abound, he should be screened both 
night and day. The germ of malaria can be 



worm. 



1 20 THE HEALTH-CARE OF THE BABY 

carried by a mosquito and an infant may be 
infected through its bite. Sprinkling the pil- 
low and bedclothing with a teaspoonful of 
alcohol to which ten drops of oil of sassafras 
has been added, has a tendency to keep mos- 
quitos away. 

Ring- A ringworm produces a round, red mark 

about the size of a twenty -five cent piece, 
sometimes larger. It is most frequently found 
on the forehead or scalp; it may, however, 
attack any part of the body. It is caused 
by a fungus which can be conveyed from 
person to person. If it appears on the scalp 
the hair should be cut short and the affected 
part painted with tincture of iodine. The 
cap, towel and everything coming in contact 
with the ringworm should be destroyed or it 
will convey the disease. 



CHAPTER IX 
ACCIDENTS AND EMERGENCIES 

IF the burn is mild and the skin but slightly Bums 
broken, dust corn-starch or wheat flour 
over the burned area. Exclude air from the 
wound with a gauze bandage. If the burn is 
severe and blisters have been raised they 
should be opened with a new clean needle, 
and after the water has been emptied from the 
blisters, linseed oil and lime-water in equal 
parts should be applied by saturating steril- 
ized cheese-cloth or clean linen. No one 
should think of treating a severe burn without 
consulting a physician. 

If a splinter enters the flesh it should be splinters 
removed with the aid of a clean, sharp needle 
and the part bathed thoroughly with witch- 
hazel. If a needle-point is imbedded and is 
difficult to dislodge a physician should be 
consulted. Frequently needle-points become 
so deeply lodged that an X-Ray examination 
must be made to locate them. 

121 



122 THE HEALTH-CARE OF THE BABY 



Bumps 

and 

Bruises. 



Cuts. 



Foreign 

Bodies 

in the 

Throat 

or 

Stomach. 



If a child falls and has a bump or a bruise, 
ice-cold cloths or cotton saturated with lead 
and opium wash should be applied. In the 
absence of lead and opium wash witch-hazel 
may be applied. 

If the skin is lacerated or torn and bleeds 
freely the wound should be washed with a 
one per cent, carbolic solution or with a 
1-2000 bichloride solution. It is necessary 
to wash the wound at least twice a day and 
apply a piece of iodoform gauze and a band- 
age over the wound. No one should dress a 
wound without thoroughly scrubbing his 
finger nails and hands. By introducing dirt 
from fingers or nails blood-poisoning can re- 
sult. 

If blood spurts from the wound, an artery 
has been cut and we should tie a handkerchief 
or a stout piece of muslin over the wound until 
a physician can be summoned. 

If the cut is very slight it may be washed in 
clean boiled water and tied with a clean piece 
of linen. 

If an infant has swallowed a whistle, a but- 
ton or similar foreign body, give him a thick- 
ened pap or bread soaked in milk until the 
physician can be called. If any difficulty 
with breathing is noticed give a teaspoonful 



EMERGENCIES 1 23 

of sirup of ipecac to produce vomiting. By 
this means we can frequently remove the for- 
eign body. Never give a cathartic. Holding 
baby head down, and slapping him firmly on 
the back will sometimes remove a foreign 
body from the throat. 

Hold the lids apart and with the aid of a in the Eye. 
small piece of linen, try to remove the foreign 
substance. An eyestone or flaxseed placed 
in the corner of the eye will sometimes remove 
the foreign substance. If the foreign body 
is not easily dislodged, do not tamper with the 
eye but call in a physician. 

If a very young infant has a foreign body J* the 
in the nose, tickle the nostril by inserting a 
soft, dry feather. This will make him sneeze. 
In an older child the free nostril may be held 
shut and the child instructed to blow through 
the obstructed nostril. 

No one but a physician or a trained nurse 
should attempt to syringe a nose, as there is 
danger of the liquid flowing through the nos- 
tril into the middle ear and causing an abscess. 

An insect can usually be dislodged from in the Ear. 
the ear by pouring'one or more drops of sweet 
oil into the ear. A bead or similar substance 
can be removed by syringing the ear with 
lukewarm water. Do not use any hairpins or 



124 THE HEALTH-CARE OF THE BABY 

button-hooks to dislodge foreign bodies. As 
a rule, more harm can be done by meddling 
with a deep-seated substance than by leaving 
the ear alone until a physician can be con- 
sulted. 

Poisoning. If a child has swallowed a poison, castor- 
oil should be given. If possible a dose of 
ipecac should follow in a few minutes the 
castor-oil. If an acid such as carbolic or oxalic 
has been swallowed, then olive-oil should be 
forced down the child's throat. Bicarbonate 
of soda and water may be given if any acid 
has been swallowed. Warm or cold milk 
may be given as an antidote to any poison, 
until the physician arrives and uses the stom- 
ach-pump to empty the stomach of its poison- 
ous contents. If a poison similar to an over- 
dose of paregoric has been swallowed and 
baby is in a stupor, then give several drops of 
whisky in water, and repeat every half-hour. 
Give a mustard foot-bath. If the stupor per- 
sists combine whisky with hot coffee. 

Bleeding. When bleeding comes from any part of the 
body apply styptic cotton to the bleeding sur- 
face and bandage tightly. Powdered alum 
sprinkled on absorbent cotton is also useful 
to stop bleeding. 

If the finger is cut or scratched and bleeds, 



EMERGENCIES 1 25 

wash it in clean cold water and bandage 
tightly with a clean bandage. 

Nosebleed can be stopped by inserting 
into the bleeding nostril a small piece of ab- 
sorbent cotton soaked in tincture of iron. 
Small pieces of ice held against the nose will 
frequently stop the bleeding. 



CHAPTER X 

EAR AND EYE 

Earache. VVTHEN the baby has earache he will cry 
▼V and scream continuously. As a rule 
he will put his hand to the affected side of 
his head, or press his head deep into the pil- 
low. Babies suffering with earache invari- 
ably rub their gums so that they sometimes 
convey the impression that they are teething. 
In some instances the head will be thrown 
back and the baby will appear to have a spasm 
of the muscles of the neck. When the affected 
ear is touched, baby will usually jump and 
scream with pain. 

A small hot-water bag should be covered 
and placed on the pillow and the baby al- 
lowed to rest his head on it. If this does 
not help the ear should be syringed with warm 
chamomile tea or with a teacupful of warm 
water containing one-half teaspoonful of bi- 
carbonate of soda. A small bag containing 
salt may be warmed and applied for its dry 
warmth behind the ear. Do not stick hair- 

126 



EAR AND EYE 1 27 

pins or other substances into the middle ear 
but rather consult a physician if the symp- 
toms do not subside after these remedies have 
been tried. 

A running ear that follows influenza, meas- Running 
les or scarlet fever requires careful antiseptic 
treatment. There is always a possibility of 
a running ear extending through into the 
deeper portions known as the mastoid cells. 

For a simple running ear, the ear may be 
washed with a teacupful of warm water con- 
taining one teaspoonful of bicarbonate of 
soda. This should be slowly injected into 
the ear by means of a small glass ear syringe. 
Powdered alum or boric acid, one-half tea- 
spoonful to a half pint of warm water, tem- 
perature 105 F., may be syringed into the 
ear night and morning. 

Projecting ears can be corrected by having Projecting 
the baby wear a thin but tight-fitting cap every 
night and during the day while asleep. The 
younger baby is, the easier this trouble will be 
corrected. At any age it will take months of 
constant treatment. 

If baby wakes up in the morning with a crusted 
cold in the head we may find pus oozing from ye * ! 
the eyes, and also find that the lids are glued 
together by this pus drying and forming 



128 THE HEALTH-CARE OF THE BABY 

crusts. These crusts can be softened and 
loosened from the eyelashes by soaking them 
in boric acid solution (a pinch of boric acid 
to a wineglassful of lukewarm water) ap- 
plied on absorbent cotton. The lids should 
be bathed with this solution several times a 
day. 



T 



CHAPTER XI 

BAD HABITS, ETC. 

HE habit of thumb sucking is usually Thumb 
formed at or about the period of den- 
tition. An irritant gum will seem to be re- 
lieved by the pressure of the finger. This 
habit may continue long after the child is 
through teething. The application of tinc- 
ture of aloes or a two per cent, quinine solu- 
tion to the fingers will in many instances break 
up his habit, owing to the bitter taste. 

Nail biting is usually found in ^nervous Nail 
children and is especially noticed when these 
children are frightened. Correction by rea- 
soning, scolding or spanking is seldom effec- 
tual. Place gloves on the child's hands con- 
stantly day and night as a reminder. If the 
habit continues in spite of the gloves, apply 
tincture of aloes to the nails and finger-tips 
night and morning. 

When children over three years of age wet Bed 

, , i . , i. • r i Wetting 

the bed at night a distinct reason for the same 
exists. In a boy a tight foreskin may cause 

129 



Biting. 



130 THE HEALTH-CARE OF THE BABY 

irritation and require circumcision. In girls 
worms wandering from the rectum into the 
vagina may irritate the opening of the bladder. 
At times the urine is at fault and must be cor- 
rected by proper diet. Meat should be 
stopped. Milk, eggs and fruit may be given. 
The foot of the bed should be elevated and 
the bladder emptied the last thing before re- 
tiring. Electricity may be necessary to re- 
store the tone if weak bladder muscles exist. 
Electricity should only be given by a phy- 
sician. 
Mastur- By masturbation is meant playing with or 
fumbling the genital organs. This is usually 
done with the hand or by rubbing the thighs 
together. When very young infants mastur- 
bate they rub their thighs together continu- 
ously until exhausted. They become very 
red in the face, and when restrained become 
very irritable. When older children mastur- 
bate they become very pale and anemic, 
they are absent-minded and shy, they fre- 
quently complain of headaches and have very 
irritable attacks. This is not always a bad 
habit but frequently is caused by some ab- 
normality of the genital parts. In such cases 
nothing but surgical relief will affect a cure. 
It may be caused by an irritation due to an 



bation. 



BAD HABITS 131 

elongated or firmly adherent foreskin, or in 
girls when the skin over the clitoris is adher- 
ent. It may also be caused by the presence 
of worms or if the genital parts are not kept 
clean. Moral training is useless if any irri- 
tation exists which excites this desire, there- 
fore, as soon as this habit is noted the child 
should receive prompt medical aid. All 
children should be constantly watched to see 
if this habit is forming and they should never 
be permitted to sleep with their hands under 
the bed clothing. 



CHAPTER XII 

WORMS 

Worms. A FTER the first year when children re- 
<** ceive some solid food in addition to their 
milk diet they may be troubled with worms. 
The majority of children seen by me, whose 
mothers suspect worms, rarely, if ever, have 
worms. Thread-like worms resembling spool 
cotton can be plainly seen when examining 
the rectum. As a rule there is an intense 
itching which compels the child to scratch. 
Restlessness at night and loss of appetite are 
rarely due to worms. It is true that an oc- 
casional case may be troubled with worms, 
but let a physician see the child and let him 
administer the worm medicine rather than 
run the risk of giving powerful medicines 
which are not at all necessary. 

Round worms, five or six inches long and 
brown in color, have been seen by me in young 
children. About two cases out of one hun- 
dred in which worms were suspected have 
really proven to be worm cases. When tape- 
worm is present we usually have loss of flesh, 

132 



WORMS 133 

although the child will take a fair amount of 
nourishment. It is only these tapeworm 
cases, found in children between six and 
twelve years of age and requiring careful diet 
besides expulsive treatment, that need cause 
any concern. Severe bleeding from the bowel 
has been seen by me when an anxious mother 
gave a strong patent tapeworm medicine, 
thinking that on general principles the child 
had worms. 

If the foreskin is tight and has a pin-point Tight 

. r Foreskin. 

opening it may cause a series of symptoms, 
among them bedwetting, irritability and in- 
somnia. Such children usually fumble with 
the parts as there is constant irritation. 

In some cases we can widen the foreskin 
with a dilator. This should only be at- 
tempted by a physician. With proper oiling 
every day relief is frequently given. If this 
stretching does not give permanent relief from 
the sleeplessness and the irritability then we 
must resort to circumcision. 

The operation of circumcision is verycircum- 
simple. Many cases of nervousness, such as 
St. Vitus dance, can be cured by this opera- 
tion. When adhesions of the foreskin form 
and there is a contracted prepuce, then cir- 
cumcision will be demanded. 



cision. 



Poultice. 



CHAPTER XIII 

EXTERNAL APPLICATIONS, AND THE 
MEDICINE CHEST 

Flaxseed |NTO a pint of boiling water stir flaxseed, 
A also known as linseed, until it forms a paste 
just thick enough to flow from a spoon; add 
a tablespoonful of sweet oil or glycerin; spread 
it one-half inch thick between two layers of 
cheese-cloth; apply where directed and cover 
with a layer of cotton, warm flannel or oil silk. 
If the part to be poulticed is anointed with 

Mustard sweet oil or vaselin before the poultice is ap- 
plied, no blisters will be raised. 

To make a mustard poultice take one tea- 
spoonful of mustard and six teaspoonfuls of 
wheat- flour, add two teaspoonfuls of sweet oil 
or glycerin and enough warm water to make 
it into a thick paste. Spread between two 
layers of cheese-cloth, and apply to the part 
directed, after anointing the same with vase- 
lin. This poultice can be left on only a few 
minutes and when removed the skin should 

134 



Poultice. 



THE MEDICINE CHEST 1 35 

again be anointed with vaselin or dusted with 
corn-starch. 

To give a mustard foot-bath, tie one table- Mustard 
spoonful of German mustard into a cheese- bath. 
cloth bag. Let this soak for a few minutes in 
a foot tub containing two quarts of warm 
water, temperature 105 F. The feet should 
be immersed to above the ankles for about 
two minutes. On removing the feet, place 
them near a hot-water bottle or wrap them 
in a warmed towel. 

A turpentine stupe is made by adding one-Turpen- 
half teaspoonful of spirits of turpentine to 
one pint of boiling hot water and mixing 
thoroughly. Dip two thicknesses of flannel 
into this turpentine and water and wring out 
until it does not drip. Apply where directed 
and cover with a large piece of cotton or oil 
silk. 

A pneumonia jacket should be shaped like Pneu- 

• mon i a 

baby s sleeveless shirt. A layer of cotton is Jacket. 
placed between a layer of cheese-cloth and 
one of oil silk. The edges are turned in and 
the three layers basted together. The shoul- 
der seams or straps may be sewed together 
or tied with tapes. The front is closed by 
means of tapes sewed on either side. The 
jacket is worn with the layer of cheese-cloth 



136 THE HEALTH-CARE OF THE BABY 

next to the skin. Two jackets should be 
made so as to have a change when one gets 
moist. 

Hot- A hot-water bottle should be half-filled with 

Bottle. hot water, the air expelled by pressing the 
empty part of the bag together, and the top 
screwed on. The bag should then be held 
upside down to see if the water drips. Draw 
over the bottle a flannel cover or sew the bottle 
in a, square of flannel. 

ice-Bag, An ice-bag should be half filled with crushed 
ice, the air expelled and the top screwed on. 
If an intense cold is desired a little common 
salt may be added to the crushed ice. A 
layer of moist cheese-cloth or cotton should 
be laid between the bag and the skin, other- 
wise the extreme cold is painful. If the weight 
of the bag is uncomfortable to the patient, 
especially if applied to the head, then the bag 
may be wrapped in cheese-cloth and pinned 
to the pillow, so suspended as to barely allow 
it to touch the head. The bag must be re- 
filled before all the ice has melted. 

Cold Cold compresses are made of three or four 

thicknesses of linen wrung out of cold water 
and applied where directed. Two com- 
presses should be used, one of which is kept in 
the cold water while the other is on the patient. 



Compress. 



THE MEDICINE CHEST 1 37 

To give a simple enema, ordinary suds are Enema. 
made with castile or glycerin soap and warm out the 

& J r Bowels.) 

water, temperature ioo° F. A fountain syringe 
should be used, to which an infant's size 
nozzle is attached. Fill the bag with the 
amount of suds ordered (usually one or two 
pints) and anoint the nozzle with vaselin. 
Open the spring clasp on the tube and allow 
the air and a few ounces of water to escape. 
Gently insert the nozzle into baby's rectum 
and allow the water to flow in a slow, steady 
stream, the bag being held about two feet 
over the baby's body. 

A chamomile injection is made and given chamo 
in the same manner as a simple enema, only irrigation. 
chamomile tea, temperature ioo°, made by 
steeping one tablespoonful of chamomile 
flowers in a quart of boiling water, is used 
instead of the soap suds. 

The baby should have his own ointments, The 

ill Medicine 

fountain syringe, etc. These should be keptcioset. 
in the nursery away from disinfectants and 
poisonous drugs. When the baby travels or 
when going to the country, a full and fresh 
supply of all drugs and requisites he is likely 
to need should be taken along. The follow- 
ing list should be supplied and will meet al- 
most all emergencies: 



138 THE HEALTH-CARE OF THE BABY 



Castor-oil 

Sweet spirits of niter 

Sirup of ipecac 

German mustard 
(ground) 

Chamomile flowers (Ger- 
man) 

Alcohol 

Witch-hazel 

Glycerin 

Glycerin soap 

Vaselin 

Zinc salve 

Bicarbonate of soda 



Boric acid powder 
Pure talcum powder 
Eyestone or flaxseed 
Absorbent cotton 
Cheese-cloth 
Gauze and muslin band- 
age 
Thermometer 
Medicine dropper 
Medicine glass 
Ice-bag 

Hot-water bottle 
Fountain syringe 
Small glass syringe 



INDEX 



Abdominal band, 18, 39 

Abscesses See Boils. 

Abnormal movements, 37 

Accidents, 121 

Adenoids, 54, 113 

Airing, the baby, 5, 32; the 

bedclothes, 4 
Albumin water, 80 
Alcohol sponge bath, 102 
Ankle support, 22 
Antidotes for poisons, 124 
Appetite, loss of, 44, 97 
Artificial feeding, 60 

B 

Baby carriage. See Carriage. 

Backward children, 28 

Bad habits, 41, 129 

Baked flour, 83 

Band, flannel, 18; knit, 18 

Barley, gruel, 80; water 79 

Bath, alcohol sponge, 102; 
bran, 116; cold sponge, 31; 
daily, 15; first, 9; how to 
give, 10; oatmeal, 15, 116; 
oil, 9; requisites for, 9; sea 
salt, 98; sun, 98; temper- 
ature of, 10; thermometer, 
10; when to give, 14 

Bathing, apron, 10; the ears, 
12; the eyes, 14: the fore- 
skin, 12; the mouth, 13; 
the nose, 12; the scalp, 12; 
when to stop, 16 

Bed, 4; clothing, 4; airing, 4 



Bedwetting, 114, 129 

Beef, scraped, 83 

Beef broth, 81; juice, 81 

Bibs, 43 

Bites, mosquito, 1 19 

Bladder, 36 

Blankets, 22; pinning, 21 

Bleeding, 122, 124; gums, 98; 
nose, 99, 125 

Blisters, 121 

Boils, 1 19 

Boric acid solution, 13 

Bottle feeding, 62, 64; uten- 
sils required for, 62 

Bottles, 62; how to clean, 62 

Bowels, 35, 49. See Move- 
ments. 

Bow-legs, 19, 97 

Bran bath, 1 16 

Breast feeding, 50, 52 

Breast milk, 50; scanty, 55; 
poor, 59 

Broths, 81 

Bruises, 98, 122 

Bumps, 122 

Burns, 121 



Carbolic acid poisoning, 124 

Carriage, 33; furnishings, 33; 
sitting up in, 34; feeding 
in, 34; sleeping in, 34 

Carrying the baby, 3 1 

Cathartics, 94 

Chafing, 1 17 

Chair, toilet. See Commode. 

Chamomile injections, 137 



139 



140 



INDEX 



Chapped hands and face, 118 

Chicken broth, 81 

Chicken-pox, 107 

Circumcision, 133 

Clothing, 18; at night, 24; 
how to put on, 23; not 
enough, 24; street, 24; too 
much, 24, 117; when to 
shorten, 23 

Cold in the head, 6, 16, 105, 112 

Cold spinal douche, 1 1 

Colic, 38, 88, 95 

Colostrum, 52 

Commode, toilet, 35 

Compresses, cold, 136 

Condensed milk, 97 

Constipation, 51, 64, 75, 91; 
massage for, 92; in rickets, 
98 

Constitutional diseases contra- 
indicating nursing, 55, 60 

Contagious diseases and fevers, 

Convulsions, 89, 100, 103 

Cool sponge baths, 3 1 

Cough, whooping-, in; croup, 
109 

Cows' milk for infant feeding, 
60; to preserve, 61 

Creeping, 31 

Crib. See Bed. 

Croup, false, 109; true, no 

Croup kettle, 109 

Crusted eyelids, 127 

Crying, 30; causes of, 38, 126 

Cry, normal, 38 

Custard, 82 . 

Cuts, 122, 124 

Cutting of teeth. See Denti- 
tion 



Dentition, 43 
Development, 26 



Diaper, 19, 117; quilted pad, 

19 
Diarrhea, 72, 76 
Digestion, 95; weak, 67 
Diet for a child from 1 year to 

18 months, 78 
Diet for a child from 18 months 

to 3 years, 78 
Diet for a nursing woman, 54 
Diphtheria, 108 
Disinfection, 104, 107 
Dress, 21 
Drooling, 27, 43 
Drugs for constipation, 94; for, 

the medicine closet, 138 
Dusting, 3 



Earache, 39, 126 

Ears, foreign bodies in, 123; 

projecting, 127; running, 

127; to clean, 12 
Eczema, 1 16 
Egg, soft-boiled, 82; water. 

See Albumin Water. 
Emergencies, 121; drugs for, 

Enema, 93, 101, 137 

Eruption, 16, 102; in chicken- 
pox, 108; eczema, 116; 
hives, 1 18 

Erysipelas, 42 

Eskay's food, 75, 92 

Exercise, 3 1 

Experimental feeding, 7 

External applications, 134 

Eyelids, crusted, 127 

Eyes, sore, 127; to clean, 14 



Face, chapped, 1 18 
False croup, 109 



INDEX 



141 



Feeding, a baby with weak 
digestion, 67, 71; a nor- 
mal baby, 64; artificial, 
60; breast, 50; bottle, 62; 
during constipation, 91; 
during diarrheal period, 72, 
76; during fever, 102; dur- 
ing the day, 52; during the 
night, 52; experimental, 7; 
general, 49, out of doors, 34 

Fever, 16, 44, 100, 103; scar- 
let, 107 

Fingernail biting, 129 

Fingernails, 14 

First outings, 32 

Flax seed poultice, 134 

Fontanel, 12, 28, 97 

Food formulas, from birth to 
6 months, 65 ; from 6 months 
to 1 year, 66 

Food recipes, 79 

Food, home preparation of, 64; 
Eskay's, 75; Horlick's, 75; 
malted milk, 75, 92; Mel- 
lin's, 75, 92; Nestle's, 75, 
76; patent, 73 

Foot-bath, mustard, 135 

Foreign bodies in the ear, eye, 
nose, throat and stomach, 
122 

Foreskin, tight, 129, 133; to 
clean, 12 

Foul breath, 13, 1 14 

Fresh air, by day, 5; at night, 6 

Fright, 39 

Fruits and fruit juices for con- 
stipation, 92 



Gelatin pudding, 82 

General rules for contagious 

diseases and fevers, 103 
German measles, 106 
Glands, swollen, 108, 114, 115 



Goat's milk, 96 

Go-cart. See Carriage. 

Growth, 26 

Gruels, 80 

Gums, bleeding, 98; spongy, 98 



H 

Hair, 14, 26 

Hands, chapped, 118 

Hardening, 12; by cold sponge 

baths, 31 
Headache, 99, 107, 130 
Heating the nursery, 6 
Height, 26 
Hiccup, 89 
Hives, 1 18 

Home preparation of food, 64 
Horlick's food, 75 
Hot-water bottle, 136 
How to hold the baby while 

nursing, 53 



Ice-bag, 136 

Indigestion, 68 

Infant food, home preparation 

of, 64 
Injections into the bowels. See 

Enema. 
Irrigation of the bowel. See 

Enema. 



j 

Jacket, pneumonia, 135 
Jaundice, 99 
Joints, swollen, 98 
Junket, 81 



K 



Kicking, 31 



142 



INDEX 



Laxative. See Cathartic. 
Legs, bow, 19, 97 
Lemonade, nutritious, 80 
Length. See Growth. 
Light, 3; at night, 3 
Linseed poultice, 134 
Loose bowels, 64, 72, 76 

M 

Malnutrition, 95 

Malted milk food, 75, 92 

Marasmus. See Malnutrition. 

Massage for constipation, 92 

Masturbation, 41, 130 

Mattress, 4 

Meals. See Diet 

Measles, 105; German, 106 

Medicine closet, 137 

Mellin's food, 75, 92 

Menstruation during nursing 
period, 55 

Mental development, 27 

Milk, breast, 52; condensed, 
97; cows, 59, 60; for a 
baby with weak digestion, 
67; Goat's, 96; how to 
heat, 63; how to pepto- 
nize, 67; peptonized, 67; 
poor, 59; scanty, 55; steam- 
ed, 61, 63 

Milk crust, 12 

Mixed feeding, 59 

Moccasins, 22 

Mosquito bites, 1 19 

Mouth, breather, 114; care of, 

13 

Movements, normal, 36; ab- 
normal, 37 

Mumps, 1 14 

Mustard foot-bath, 90, 135 

Mustard poultice, 134 

Mutton broth, 81 



N 



Nail biting, 129 

Nails, to clean, 14; to shorten, 

*4 

Napkins. See Diapers 

Naps, 40 

Navel, cord, 9; rupture of, 17; 
sore, 17 

Nervous system, 37 

Nestle's food, 75, 76 

Night air, 6 

Night clothes, 18, 24 

Nipples, 62; how to clean, 63 

Normal gain, 29 

Normal movements, 36, 49 

Nose, bleeding, 99, 125; dis- 
charge from, 113; foreign 
bodies in, 123; to clean, 12; 
plugged, 113 

Nurse-maid, 7 

Nursery, 3; heating, 6; tem- 
perature of, 6 

Nursery seat, 36 

Nursing, 53;contra-indications, 

Nursing woman, diet of, 55; 
foods prohibited, 55; men- 
struation of, 55; pregnancy 

°f> 57 
Nutritious lemonade, 80 

Nutritious orangeade, 81 

O 

Oatmeal, bath, 15, 116; gruel, 

80; water, 80 
Orangeade, nutritious, 81 
Outdoor life, 32, 34 
Overfeeding, 87 
Oxalic acid poisoning, 124 



Paregoric poisoning, 124 
Patent cathartics, 94 



INDEX 



143 



Patent foods. See Proprietary 

foods 
Peptogenic milk powder, 69 
Peptonized milk feeding, 67 
Peptonizing powders, 67 
Perspiration, 97 
Pillow, 4 

Pinning blanket, 21 
Playthings. See Toys 
Pneumonia jacket, 135 
Poisoning, 124 
Poor breast milk, 59 
Poultices, 134 
Powder, 10,11 
Pregnancy while nursing, 57 
Prickly heat, 1 17 
Proper training, 35; bladder, 

36; bowels, 35; sleep, 40; 
Proprietary foods, 73 



Q 



Quilted pad, 19 



R 

Rash, 102; German measles, 
106; measles, 105; prickly- 
heat, 117; scarlet fever, 107 

Raw scraped steak, 83 

Resting, 35 

Restlessness, 44, 45, 51, 95, 132 

Rice, gruel, 80; water, 80 

Rickets, 7, 96 

Ringworm, 120 

Running nose, 1 13 

Rupture, 17, 40 



Scales, 29 
Scalp, to clean, 12 
Scanty milk, 55 
Scarlet fever, 88, 107 



Scraped beef, 83 
Scurvy, 98 
Shirt, 20 
Shoes, 22 

Sitting up, 27; in carriage, 34 
Skin, diseases of, 116; in jaun- 
dice, 99; sensitive, 15 
Skirt, flannel, 21; white, 21 
Sleep, 40, 52, 131; disturbed, 

4°> 49 

Sleeping out of doors, 34 

Sleeplessness, 40 

Small-pox, 42 

Snoring, 1 14 

Soap, 9 

Soapstick, 35, 93 

Socks, 22 

Soft-boiled egg, 82 

Soft spot. See Fontanel 

Soothing sirups, 41 

Sore eyes. See Crusted Eye- 
lids 

Speaking, late, 28 

Speech, sudden loss of, 28 

Spasms. See Convulsions 

Splinters, 121 

Sponge bath, alcohol, 102; 
cold, 31 

Standing, 27 

Sterilization, evils of, 63 

Stomach, capacity, 64; for- 
eign bodies in, 122 

Stools, curded, 68, 71, 95; 
greenish, 68; white or clay 
colored, 99. See Move- 
ments 

Street clothing, 24 

Sucking the thumb, 129 

Suppositories, 35, 93 



Talking, 28 
Tea, weak, 82 
Tears, 27 



144 



INDEX 



Teeth, 43; care of, 13; milk 
45; permanent, 45 

Teething. See Dentition 

Temper, 39 

Temperature, 100; of bath, 10; 
of nursery, 6 

Throat, foreign bodies in, 122; 
sore. See Tonsillitis 

Thumb sucking, 129 

Tight foreskin, 129, 133 

Toast, 83 

Toilet chair. See Commode 

Tonsillitis, 1 13 

Toys, 7, 27 

Training. See Proper Train- 
ing 

True croup, 1 10 

Turpentine stupes, 135 

Twitching, 103 



U 



Urine, 36, 99 



Vaccination, 42 
Veal broth, 81 
Veil, 25 

Ventillation, 5, 104 
Vernix caseosa, 9 
Vomiting, 45, 71, 87, 95, 99; 
in whooping-cough, 1 1 1 

W 

Walking, 28, 32 

Washing out the bowels, 10 1 

Water, 44, 45, 50, 92 

Weaning, 50 

Weight, 29; gain in, 49; loss 

of, 95 
Weight scales, 29 
Wet-nurse, 60, 96 
Whey, 81 

Whooping-cough, 1 1 1 
Window-board, 5 
Worms, 132 
Wrapper, 22 



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